Intestinal obstruction : its varieties with their pathology, diagnosis, and treatment / by Frederick Treves.

  • Sir Frederick Treves, 1st Baronet
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Intestinal obstruction : its varieties with their pathology, diagnosis, and treatment / by Frederick Treves. 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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    uterus, the rectum, the peritoneum in the right iliac fossa, and the csecum. In all these cases I tliink that the unusual connection of parts may be explained by displacement from distension, the distension occurring duiing the development of the peritonitis. Thus the transverse colon when distended is apt to become bent uj^on itself, and by such bending to reach the lower parts of the abdomen. In the same way the distended sigmoid flexure may turn down into the pelvis, or extend across to the right iliac region, or even mount up in the abdomen and reach the liver. In addition to the causes of obstruction already alluded to, peritonitis may be the means of bringing about an occlusion in the intestine by other and very difterent methods. The adhesions may form a part of the bowel into a rigid loop, they may bend it so acutely as to greatly narrow or even entirely obstruct its lumen, they may lead to obstruction by kinking, or they may bring about an arrangement of certain coils of small intes- tine or of the loop of the sigmoid flexure that especially favours the production of a volvulus. In another series of cases as a result of local peritonitis, the omentum or the tip of the appendix vermiformis has become adherent at one point, and beneath the arcade so formed coils of intestine have been strangulated. Similar arcades have been formed by the adhesion of the point of a free Meckel's diverticulum, and of the outer extremity of the Fallopian tube. In still another variety of case a loop of bowel has been strangulated through a slit in a membranous adhesion, or through an aperture formed by adhesions between adjacent viscera, or through the gap left between two parallel adhesions. With regard to the forms of peritonitis that may lead to adhesions capable of producing obstruction,
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