. American practice of surgery ; a complete system of the science and art of surgery . and the neigh-borhood of the sigmoid flexure are locations where local peritonitis veryoften occurs. In certain conditions, the etiology of which is not definitely determined,a combination of the adhesive and the exudative forms may be present, andwith this peculiar form of peritonitis is associated a similar inflammation of some SURGICAL DISEASES OF THE INTESTINES. 753 other serous membrane—most frequently the pericardium. To such a condi-tion has been given the name multiple serositis. In diffuse adhesive
. American practice of surgery ; a complete system of the science and art of surgery . and the neigh-borhood of the sigmoid flexure are locations where local peritonitis veryoften occurs. In certain conditions, the etiology of which is not definitely determined,a combination of the adhesive and the exudative forms may be present, andwith this peculiar form of peritonitis is associated a similar inflammation of some SURGICAL DISEASES OF THE INTESTINES. 753 other serous membrane—most frequently the pericardium. To such a condi-tion has been given the name multiple serositis. In diffuse adhesive ix^ritonitis all the abdominal viscera are gathered intoa mass, and this mass usu;dly is adherent to the imrietal peritoneum. Theremay or may not be an exudate. The symptoms will be those of tumor and chronic intestinal stenosis. Treat-ment is very imsatisfactory, as breaking of the adhesions is usually followedby a recurrence. Chronic adhesive sclerosing peritonitis, or plastic peritoneal sclerosis, isquite a rare condition. It is characterized by a marked connective-tissue in-. FiG. 301.—Enteroplasty. (Original.) filtration of the peritoneum, with contraction and thickening but without anyexudate or ascites. It may follow an acute peritonitis, or it may be chronicfrom the start. It begins usually at the customary sites of a chronic reports one of the very few cases that have been observed in thiscountry, and he states that the condition is primarily not a peritonitis at all,but a distinct affection of the subperitoneal fibrous or connective tissue. Heconsiders the fact that it is not practicable, in an abdominal section upon aperson thus affected, to secure union between the opposite edges of the thick-ened and shrinking peritoneum, as pathognomonic of this disease. The well-marked subendothelial connective-tissue hyperplasia is the principal patho- voL. VII.—48 754 AMERICAN PRACTICE OF SURGERY. logical feature of the disease, and the shrinking or
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