The practice of surgery . - arise from any part of the intestine,and usually from the side opposite the mesenteric attachment. Whenyou operate for supposed appendicitis and find the appendix normal,search for a Meckels diverticulum. Its blood- and nerve-supply arethose of the intestines, as its musculature is from the intestines. Sometimes, through persistent granulation at the navel, there isexternal evidence of a chverticulum; and, when ])atulous throughout,it may form the sac of an umbilical hernia. This brief sketch of the anatomy shows that a IMeckels diverticulummay cause trouble in two
The practice of surgery . - arise from any part of the intestine,and usually from the side opposite the mesenteric attachment. Whenyou operate for supposed appendicitis and find the appendix normal,search for a Meckels diverticulum. Its blood- and nerve-supply arethose of the intestines, as its musculature is from the intestines. Sometimes, through persistent granulation at the navel, there isexternal evidence of a chverticulum; and, when ])atulous throughout,it may form the sac of an umbilical hernia. This brief sketch of the anatomy shows that a IMeckels diverticulummay cause trouble in two ways—by becoming diseased itself, like the. Fig. 21.—Meckels diverticulum (Warren Museum, Harvard, Specimen No. 7915). appendix, or by obstructing, entangling, and strangulating the gut insome fashion. Inflammation, or diverticulitis, as it has been called, has occurredin about 13 per cent, of the reported cases of diseased diverticula,^ andamong these are a few from typhoid and tuberculous ulcers. Far morecommonly it acts by strangulating the bowel as by a band—59 per cent.;while there are many cases of intussusception, or telescoping of thediverticulum (10 per cent.), of hernia (10 per cent.), and several casesof volvulus or twist about the diverticuhim. It appears that when the diverticulum forms a mere cord from gutto navel, strangulation of the intestine is probabl}- never produced. 1 Miles F. Porter, Jour. Amer. Med. Assoc, September 23, 1905, discusses 184reported cases in a valable paper, Abdominal Crises Caused by Meckels Divertic-ulum. Meckels diverticulum 59 It is the free diverticulum secondarily fixed to portio
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1910
