Modern surgery, general and operative . ugh the lesser sacrosciatic foramen. Pudendal hernia protrudes into the lower part of the labium, the bowel hav-ing descended between the ischial ramus and the vagina. Perineal hernia presents in the perineum, between the rectum and theprostate gland or between the rectum and the vagina. Internal, retroperitoneal, or intra-abdominal hernice include hernia into theforamen of Winslow, hernia into the retroduodenal fossce, the retrocecal fossa,and the intersigmoid fossa (see page 981). Vaginal hernia is associated with uterine prolapse or ensues upon destru
Modern surgery, general and operative . ugh the lesser sacrosciatic foramen. Pudendal hernia protrudes into the lower part of the labium, the bowel hav-ing descended between the ischial ramus and the vagina. Perineal hernia presents in the perineum, between the rectum and theprostate gland or between the rectum and the vagina. Internal, retroperitoneal, or intra-abdominal hernice include hernia into theforamen of Winslow, hernia into the retroduodenal fossce, the retrocecal fossa,and the intersigmoid fossa (see page 981). Vaginal hernia is associated with uterine prolapse or ensues upon destruc-tion of the vaginal wall. Richters hernia (partial enterocele or hernia of the intestinal wall. Fig. 770,a) was described by Richter in 1778. He called it the small rupture. Itoccurs only in adults and is most common in women. It is the catching of a por-tion of the circumference of the bowel, usually a portion of the lower part ofthe ileum. It is usually femoral, but may be inguinal, and even epigastric or Hernia of the Bladder 1163. obturator. It arises usually in an old, reducible hernia (Royal HamiltonFowler, Am. Jour. Surg., Jan., 1912). Some cases are due to adhesions. Itmay be due to truss pressure on an incompletely reduced hernia (Fowler, Ibid.).Strangulation of a partial enterocele may not completely close the lumen of thegut. There may not be stercoraceous vomiting or absolute constipation, andthe protrusion is barely perceptible or cannot be palpated. Littres hernia is hernia of Meckels diverticulum (Fig. 770, b). It wasdescribed by Littre in 1700. This diverticulum is the persistent vitelline ductand comes off from the ileum from 12 to 36 inches above the ileocecal arises from the convex ..^ side of the gut and rarely -wft, has a mesentery (see pages982 and 988). Rokitanskys divertic-xxlar herniae are due toseparation of the muscu-lar fibers of the bowel,permitting the sacculationof mucous membrane andperitoneum. These falsediverticula may be nolarger th
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