. Surgery, its principles and practice . in a conical projection,and may even be dilated in the form of a sac. Remains of the obliteratedblood-vessels may cause a splitting of the end into a sort of Not infrequently it forms part of the contents of a hernial sac. 668 SURGERY OF THE INTESTINES. Its structure corresponds closely to that of the intestinal wall. Thefrequency with which this diverticulum occurs is from 1 to 2 per cent.,the greater number being found in male bodies. Various morbid anatomic changes occur in Meckels diverticula cor-responding to its normal anatomic
. Surgery, its principles and practice . in a conical projection,and may even be dilated in the form of a sac. Remains of the obliteratedblood-vessels may cause a splitting of the end into a sort of Not infrequently it forms part of the contents of a hernial sac. 668 SURGERY OF THE INTESTINES. Its structure corresponds closely to that of the intestinal wall. Thefrequency with which this diverticulum occurs is from 1 to 2 per cent.,the greater number being found in male bodies. Various morbid anatomic changes occur in Meckels diverticula cor-responding to its normal anatomic structure. The analogy of the diverti-culum* to the appendix vermiformis is pronounced and is to be followedin the diseases of the two structures. Typhoid ulcers, catarrh, and per-forative or gangrenous inflammation are not infrequently noted. This very analogy makes it practically impossible to diagnosticatelesions of Meckels diverticulum, and they can be diagnostically suspectedonly when the site of inflammation is near the Fig. 372.—Meckels Diverticulum (Bunts). Where Meckels diverticulum is responsible for an intestinal distur-bance elsewhere it is better to remove the sac by excision and enteror-rhaphy. Diverticulitis.—Acute diverticulitis is a term applied to an acuteinflammation of both congenital and acquired diverticula, the formerterm almost always referring to Meckels diverticulum and the latter toall diverticula arising in later life along the intestinal canal. Inflammation of Acquired Diverticula.—It is only since 1899 thatthis subject has assumed clinical imjiortance. Previously, acquireddiverticula were looked upon as pathologic curiosities. Sidney Jones(1858) was probably the first to draw attention to their pathologic im-portance. He described a case of intestino-vesical fistula which he believed DIVERTICULA. 669 to be due to ulceration of a sigmoid diverticulum. Loomis (1877),Birch-Hirschfeld (1887), and Biggs (1894) also reported cases. Beer
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