. Annals of surgery . INTRA ABDOmTnAL COILSDRAWN DOWN To EXPOSEILEUM. Fig. 2.—Diagrammatic sketch of the conditions present in Case IX. It may alsobe consulted in connection with the description of the conditions found inCase XI. The condition found at the necropsy was as follows: The lowestfour feet or so of the ileum had undergone a single half-twist from VOLVULUS IN ASSOCIATION WITH HERNIA. 421 right to left, so that at the neck of the volvulus the termination ofthe ileum lay over and directly across the ileum at a point some feetabove the valve. The final few inches of the ileum with its m
. Annals of surgery . INTRA ABDOmTnAL COILSDRAWN DOWN To EXPOSEILEUM. Fig. 2.—Diagrammatic sketch of the conditions present in Case IX. It may alsobe consulted in connection with the description of the conditions found inCase XI. The condition found at the necropsy was as follows: The lowestfour feet or so of the ileum had undergone a single half-twist from VOLVULUS IN ASSOCIATION WITH HERNIA. 421 right to left, so that at the neck of the volvulus the termination ofthe ileum lay over and directly across the ileum at a point some feetabove the valve. The final few inches of the ileum with its mesen-tery were drawn out into a pale, empty, and narrowed band, and thehigher portion of the ileum as it passed underneath it had beenmarkedly compressed by it. The relative position of parts at theneck of the twist had not been materially altered by the upper portion of the twisted loop had suffered most, its ecchy-mosed condition and emptiness being very marked for eighteen inches Ileum acting as aband but nowrelaxed. Coils that hadoccupied thehernial sac. Fig. 3.—Photograph of the volvulus in Case IX. after passing below the end of the ileum. The lower portion of theloop was congested but not ecchymosed, and contained a fair amountof gas. The last few inches of the loop,—viz., the termination of theileum,—have been described. The greater portion of the loop had constituted the hernial con-tents. The hernia was irreducible, and the twist must have formedbefore the bowel entered the sac for the last time. As more arid moreintestine came down, the time arrived when the lower limb of thevolvulus began to pull upon the fixed ascending colon, and it was thistaut lower segment that was felt by the finger running down to the 422 R. LAWFORD KNAGGS. ring before the bowel was returned At last the tension of this bandbecame such that a very small matter led to the development of obstruc-tion and of strangulation. It has been explained that the obstacleto t
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
