. American practice of surgery ; a complete system of the science and art of surgery . , and the visceral orperitoneal cavity closes perfectly, witli rio iK)uch left in the f(etal end of theumbilical cord. If such a pouch docs remain from fcetal life it is enclosed onlyby the dilated network of cord vessels and the thin layers of Whartons jelly andthe amnion. (Figs. 242 and 243.) The opening at the tmibilicus may be excessively large and the tumor thin-. FiG. 235.—Femoral Hernia. {Original.) walled and translucent at birth, or it may be small and dense. Such congenitalsacs are analogous to the
. American practice of surgery ; a complete system of the science and art of surgery . , and the visceral orperitoneal cavity closes perfectly, witli rio iK)uch left in the f(etal end of theumbilical cord. If such a pouch docs remain from fcetal life it is enclosed onlyby the dilated network of cord vessels and the thin layers of Whartons jelly andthe amnion. (Figs. 242 and 243.) The opening at the tmibilicus may be excessively large and the tumor thin-. FiG. 235.—Femoral Hernia. {Original.) walled and translucent at birth, or it may be small and dense. Such congenitalsacs are analogous to the conditions observed in spina bifida, cleft palate, andother failures of coalescence in fcttal life. So great is the defect in some casesthat nearly all the hollow \dscera and the liver, spleen, and even the pancreasmay be contained in the hernial timior. Great danger of ulceration and fataluifection is present in the large thin-walled sacs. The smaller varieties, inwhich the hernia is covered with natural skin, are usually reducible by directpressure. ^lost of the infantile and acciuired umbilical hernias are of this kind,and attain large size only when left unsupported for long periods. Strangulated Umbihcal Hernia.—Two extremes in size of umbilical herniaare especially dangerous when strangulation takes place. The veiy smallglobular sacs, which represent one extreme, are often hidden in the panniculusand can be disco\ered only by palpation
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectsurgery, bookyear1906
