Intestinal obstruction; its varieties : with their pathology, diagnosis, and treatment.
- Sir Frederick Treves, 1st Baronet
- Date:
- 1899
Licence: Public Domain Mark
Credit: Intestinal obstruction; its varieties : with their pathology, diagnosis, and treatment. Source: Wellcome Collection.
Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.
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![altliougli the pro^^ortion of cases of strangulation by a noose or knot is greater in the former than in the latter class of adhesion. This circumstance is no doubt due to the greater average length, and the greater inobilitj of the omental false ligament.^ 3. Strangulation by Meckel's Diverticulum.—The true or ]\Ieckers diverticulum is due to the persistence or in- complete obliteration of the vitelline or omphalo-mesenteric duct. It occurs in about 2 per cent, of the bodies examined, and is a little more common in males than in females. When met with in its most j^erfect condition it exists as a tube, having a structure similar to that of the small intestine itself, and extends between the lower j^art of the ileum and the umbilicus. The abdominal end of the tube opens into the lumen of the lesser bowel, while the umbilical extremity may be closed, or may open upon the surface and permit of the free discharge of ftecal matter. I have myself met with tw^o cases w^here such discharge took place. Once in a lad, aged seventeen, who had been troubled smce birth with the occasional escape of faeces from a sinus at the navel, and once in a male infant a few weeks old, where a like condition existed, and upon whom I successfully performed a plastic operation for the closure of the abnormal passage. Mr. Bernard Pittsf reports a case in which a ftecal dis- charge at the umbihcus, due to a Meckel's diverticulum, appeared when the child was three wrecks old, persisted for seven years, and then ceased spontaneously. The opening at the umbilicus may be so wide that the mucous membrane of the diverticulum may prolapse and form a spur, on either side of which will be a very apparent opening into the ileum. These conditions, however, of the diverticle are com- paratively rare. Most commonly it exists as a blind tube coming off from the ileum. The length of this tube is on an average two to three inches, and in the great majority of the examples the measurement extends between one inch and four. Sometimes it exists only as a nipple-like projection, j On the other hand cases are recorded where the diverticle, in the form of a free tube, attained the length of ten inches. As a rule the abnormal tube is cylindrical in shape, with a conical extremity. In nearly every instance the intestmal end of the diverticulum is larger than its opposite extremity. * Lancet, vol. ii., 1873, p. 773. t Trans. Path. Soc, vol. xxxiii., p. 14-5.](https://iiif.wellcomecollection.org/image/b21205516_0058.jp2/full/800%2C/0/default.jpg)
