Surgery; its theory and practice . e inflammatory thickening and contraction, andfrom elongation of the neck of the sac. 3. Inside the sac, from(«) the great bulk of the intestine or omentum due to increasedgrowth subsequent to their descent; {b) constriction of theomentum at the situation of the ring and expansion of the lowerpart; (r) adhesion of the intestine or omentum to the sac, or toone another ; (<•/) bands of adhesions stretching across the sac,and so confining a loop of intestine or knuckle of omentum ; (^) acollection of fluid in the sac; (/) a portion of intestine (as thecaecum)
Surgery; its theory and practice . e inflammatory thickening and contraction, andfrom elongation of the neck of the sac. 3. Inside the sac, from(«) the great bulk of the intestine or omentum due to increasedgrowth subsequent to their descent; {b) constriction of theomentum at the situation of the ring and expansion of the lowerpart; (r) adhesion of the intestine or omentum to the sac, or toone another ; (<•/) bands of adhesions stretching across the sac,and so confining a loop of intestine or knuckle of omentum ; (^) acollection of fluid in the sac; (/) a portion of intestine (as thecaecum) having descended uncovered with peritoneum on oneaspect, the uncovered portion forming adhesions with the tissuesaround it where the sac is absent. The symptoms are similar to those of the reducible form, save 628 DISEASE? OF REGIONS. that the hernia cannot be completely reduced. Thus, there isimpulse on coughing, non-translucency, and when it contains in-testine, gurgling on handling, and resonance on percussion. It Fig. Greig Smiths method of performing the radical cure ol umbilical hernia. A. sec-tion through hernia and parietcs, showing sac, contents, ring, and lines of incision, i , o M. Omentum, s K. Skin. F. Fascia, thickened at margin of ring. M. Rec-tus muscle, p. Peritoneum, i. Incision through the skin of sac, which is continued alongthe subperitoneal tissue to margin of rmg. 2. Same on opposite side. Between i and 2skin and sac are removed on free surface, and sac on deep aspect. 3 and 4. Incisions car-ried deeply through thickened fascia round umbilical ring 10 expose recti. H. Gut returned,omentum removed, superfluous skin and sac removed, sutures placed, incisions in fasciaopened up and recti exposed. References same as in A. C. Sutures tied, .skin .suture toone side of parietal line of junction. D. Birds-eye-view showing double set of suturesaround umbilical ring and cutaneous wound. I,From a drawing by .Mr. Greig Smith.) , mo
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectsurgery, bookyear1896
