. Annals of surgery . ^ ^\ X of Po-uch. p^i5lG\iS Fu;. 7.—.Same; posterior view. Case II. The oesophagus w^as readily found by a dissection of the neckthrough an incision five inches in length along the anterior borderof the left sterno-cleido-mastoid muscle. No important structurewas divided except the anterior belly of the omohyoid muscle. Apouch was discovered Ijehind the upper portion of the oesophagus. (ESOPHAGEAL DIVERTICULUM. 537 The base of the pouch was attached at the posterior surface of thebeginning of the oesophagus and the lower border of the pharynx(Figs. 6 and 7). The fundus of
. Annals of surgery . ^ ^\ X of Po-uch. p^i5lG\iS Fu;. 7.—.Same; posterior view. Case II. The oesophagus w^as readily found by a dissection of the neckthrough an incision five inches in length along the anterior borderof the left sterno-cleido-mastoid muscle. No important structurewas divided except the anterior belly of the omohyoid muscle. Apouch was discovered Ijehind the upper portion of the oesophagus. (ESOPHAGEAL DIVERTICULUM. 537 The base of the pouch was attached at the posterior surface of thebeginning of the oesophagus and the lower border of the pharynx(Figs. 6 and 7). The fundus of the pouch was easily separatedfrom the prevertebral space, and withdrawn from the wound at aright angle with the oesophagus. The pouch was opened and ex-plored, as in the preceding case. With the finger in the pouch,the probang introduced through the mouth could be guided into. P>iSi,TLm-x _Cu,t eclqe of \oo^.icyu —l^cLSi on Fig. 8.—Case II. Showing posterior view of pharynx and oesophagus. Thepouch has been cut off, leaving a circular margin about the sac. The dottedline shows incision through margin of pouch, neck of pouch, and constric-tion of the oesophagus. 0 the oesophagus. The index-finger was next passed carefullythrough the neck of the pouch into the oesophagus. A constric-tion lined with friable mucous membrane was here found. Pas-sage of the finger through this constricted portion resulted in alongitudinal tear, which seemed to involve the greater part of thelining. The probang. after being passed by this constriction,could at one time be introduced into the stomach: at another it 538 MAURICE H. RICHARDSON. could not. It seemed at the time to meet with an obstructionlower down. The parts were repeatedly examined to determinethe exact shape, size, and position of the pouch, and its relationswith the oesophagus and pharynx. The pouch was smal
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
