. Abdominal hernia : its diagnosis and treatment. M. G., 40 years of age. Irreducible left scrotal hernia packed with intestine on peculiarhypertrophied mesentery. Duration, 20 years. Never retained. by this peculiar hypertrophied (if it may be so called) mesen-tery. The ultimate termination of this case, if it had not beenoperated upon, would in all probability have been by intestinalobstruction produced by gradual loss of peristalsis in the pro-truding bowel. I have seen only one other case at all similar,nor do I recall having seen mention of any like it by otheroperators. 276 ABDOMINAL HER
. Abdominal hernia : its diagnosis and treatment. M. G., 40 years of age. Irreducible left scrotal hernia packed with intestine on peculiarhypertrophied mesentery. Duration, 20 years. Never retained. by this peculiar hypertrophied (if it may be so called) mesen-tery. The ultimate termination of this case, if it had not beenoperated upon, would in all probability have been by intestinalobstruction produced by gradual loss of peristalsis in the pro-truding bowel. I have seen only one other case at all similar,nor do I recall having seen mention of any like it by otheroperators. 276 ABDOMINAL HERNIA. My other case was in a woman with enormous femoralhernia shown in the photograph, fig. 169, and even this did not Fig. Intestine which was irreducible on account of hypertrophy and hardening of its mesentery. present the extreme difficulties met with in the case underconsideration. CHAPTER , C-a:CAL, AND BLADDER HERNIA. Hernije of the sigmoid, caecum, and bladder, belong to thedirect t3pe of inguinal hernia and are classed together becauseof similar anatomical peculiarities. In the accidents whichmay occur during the operation for their cure they are alsosimilar. In the chapter on diagnosis will be found suggestionswhich may, in some instances at least, lead to the recognitionof sigmoid and csecal hernia before the operation; in manyothers, however, there are no distinguishing signs previous tothe opening of the parts, and even then serious mistakes may bemade. It is perhaps wise to look upon all direct hernise asextra-hazardous and to use extraordinary care in operatingupon them. Petit {Recherches sur Ics causes des hernies) hastruly said that hernial sacs are full of deception. My own ex
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