. On retro-peritoneal hernia . tro-peritoneal hernia practically did not exist. It was he whofirst recognised that such herniae occur in fossae which arenormal, and it was he who first gave us any intelligentdescription of the fossai and their probable mode of says : If in a body with a normal peritoneum one hfts HISTORY OF THE FOSSM up the great omentum and the transverse colon, and pushesover to the right the mass of small intestines, there will beseen on the left side of the duodeno-jejunal flexure a peri-toneal fold (Fig. 3). This fold varies in shape and frequently it
. On retro-peritoneal hernia . tro-peritoneal hernia practically did not exist. It was he whofirst recognised that such herniae occur in fossae which arenormal, and it was he who first gave us any intelligentdescription of the fossai and their probable mode of says : If in a body with a normal peritoneum one hfts HISTORY OF THE FOSSM up the great omentum and the transverse colon, and pushesover to the right the mass of small intestines, there will beseen on the left side of the duodeno-jejunal flexure a peri-toneal fold (Fig. 3). This fold varies in shape and frequently it is semilunar, the thin concave edgelooking upwards and to the right, and surrounding thebowel at the level of the flexure. The upper horn of thissemilunar fold is blended with the inferior layer of thetransverse mesocolon, and especially at the point wherethe inferior mesenteric vein passes beneath the larger lower horn is continuous on the inner side withthe peritoneal investment of the duodenum, and at the outer. Fig. 4.—The Vascular Arch of Treitz. end with the peritoneum of the transverse and descendingmesocolon. In the upper horn, at a variable distance fromthe edge, lies the inferior mesenteric vein, forming an arch,with the convexity looking upwards and to the left. Thelower horn is less distinct, composed exclusively of two layersof peritoneum, and, at some distance from its free border,one sees the inferior mesenteric artery and its branch, theleft colic artery. IVom the relative positions of these twovessels there results a vascular arch (always referred to nowas the Arch of Treitz) which surrounds the fold in question(Fig. 4). Behind this peritoneal fold—between it and theduodenum—there exists, necessarily, a depression or pocketin the form of a funnel, the summit of which is directed 22 THE DUODENAL FOLDS AND FOSSyE towards the duodenum. The orifice of entry is semilunar,limited on the right by the intestine, the flexura duodeno-jejunalis; on the
Size: 1218px × 2051px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookauthormoynihanberkeleymoyni, bookcentury1800, bookdecade1890
