. Southern medicine and surgery [serial]. main vessel. Sclerosis of thesesmall vessels causes contraction. Such contractions,however minute, lead to a weakening of the intes-tinal walls. At such points of weakness small sacsare first formed followed by herniation, and finally Carolinas and Virginia, meeting :ii Norfolk, February 22nd DIVERTICULA OF THE JEJUNUM—Johns June, 1937 by diverticulosis. Further evidence gained frommicroscopic examination shows that the longitudinaland circular muscular fibres, if present, are greatlythinned. In support of this theory is the fact thatjejunal diverticul
. Southern medicine and surgery [serial]. main vessel. Sclerosis of thesesmall vessels causes contraction. Such contractions,however minute, lead to a weakening of the intes-tinal walls. At such points of weakness small sacsare first formed followed by herniation, and finally Carolinas and Virginia, meeting :ii Norfolk, February 22nd DIVERTICULA OF THE JEJUNUM—Johns June, 1937 by diverticulosis. Further evidence gained frommicroscopic examination shows that the longitudinaland circular muscular fibres, if present, are greatlythinned. In support of this theory is the fact thatjejunal diverticula are usually found in the middle-aged, after vascular changes have begun to takeplace. disturbances, as duodenal ulcer, gallbladder disease,or simply as fullness in the epigastrium. Such errorsare probably due to the misleading absence of symp-toms in many diverticula cases; or to a misinter-pretation of the symptoms when present: or, again,to the surgeons too-great dependence on theroentgenologist when the latter has failed to study. It has been argued that pressure in the lumen ofthe bowel might be a factor in the formation ofdiverticula; but I think this hardly true, since littlepressure exists in this section of the gut. Arterio-sclerosis, plus a mild inflammatory change, is prob-ably the determining influence in the formation ofthese single or multiple sacs with their resultingdiverticula. A correct diagnosis of jejunal diverticula hasseldom been made. It appears from the reports thatmany of these cases have been treated as digestive these cases with sufficient diligence. We must alsoalways bsar it in mind that in certain cases thediverticula do not show on x-ray examination,however thorough. Always, in th; report that di-verticula are not found, it should be stated thatthis does not preclude the possibility of their pres-ence. The symptoms in this disease may vary fromthe mildest to complete obstruction and both physical and laboratory examinations thesm
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectmedicine, bookyear192
