. Surgery, its principles and practice . um is forced like a thin wedge, gradually dilating the opening mitil awell-marked hernia is formed. Under certain conditions a hernial sacmay be mcomplete, e. g., in sliding hernia of the cecum or sigmoid and,occasionally, in hernia of the bladder. In these cases the sac anteriorlyis like an ordinary sac, while posteriorly it is continuous with the anteriorsurface of the cecum or sigmoid. Such cases offer considerable difficultyin operations for radical cure. Figs. 1, 2, and 3 illustrate types of sacobserved by the author in operations for radical cure
. Surgery, its principles and practice . um is forced like a thin wedge, gradually dilating the opening mitil awell-marked hernia is formed. Under certain conditions a hernial sacmay be mcomplete, e. g., in sliding hernia of the cecum or sigmoid and,occasionally, in hernia of the bladder. In these cases the sac anteriorlyis like an ordinary sac, while posteriorly it is continuous with the anteriorsurface of the cecum or sigmoid. Such cases offer considerable difficultyin operations for radical cure. Figs. 1, 2, and 3 illustrate types of sacobserved by the author in operations for radical cure of hernia. In the rarer forms of internal hernia, e. g., diaphragmatic, in mostcases no sac is present. In ventral hernia following laparotomy there isa gradual thinning out of the cicatrix, forming a large pouch, in whichthere may be no sac or a partial one. In still rarer cases there may be 20 HERNIA, a rupture of the peritoneum and the contents of the sac (omentum orbowel) may pass dowiiward into the canal, covered only by muscle and.
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