. Surgery, its principles and practice . ietal Fossa.—This fossa is usually found in thefirst part of the mesojejunum, immediately behind the superior mesen-teric artery, and below the duodenum. Moynihan has found this fossapresent three times in adults; in seventeen embryos of less than five orsix months it was present in six. The mesocolic fossa is formed by a fold containing the ascending branch 100 HERNIA. of the left colic artery. It extends between the layers of the transversemesocolon toward the splenic flexure. Moynihan believes that the etiology of peritoneal fossae is best ex-plained
. Surgery, its principles and practice . ietal Fossa.—This fossa is usually found in thefirst part of the mesojejunum, immediately behind the superior mesen-teric artery, and below the duodenum. Moynihan has found this fossapresent three times in adults; in seventeen embryos of less than five orsix months it was present in six. The mesocolic fossa is formed by a fold containing the ascending branch 100 HERNIA. of the left colic artery. It extends between the layers of the transversemesocolon toward the splenic flexure. Moynihan believes that the etiology of peritoneal fossae is best ex-plained by regarding them as fusion folds between the original left, after-ward anterior, surface of the ascending portion of the duodenum and theright or anterior surface of the descending mescolon folds, which datetheir origin from the time when these two peritoneal surfaces are in closeapposition, namely, at the end of the third or the beginning of the fourthmonth. Treitz^* (in 1857) was the first to call attention to internal hernia, and. Fig. 70.—^1, Duodenojejunal Fossa ; HsicMOiD Fossa (Sultan). his careful study of the various fossae represents the first attempt at ascientific explanation of their etiology. As Moynihan states, before thetime of Treitz the subject of retroperitoneal hernia did not exist. Itwas he who first recognized that such hernias occur in fossae which arenormal, and it was he who first gave an intelligent description of theirprobable mode of de^•elopment. Duodenal hernia may be divided into left and right, the left beingthe more common. Left duodenal hernia probably originates in nearlyevery case in the paraduodenal fossa, or fossa of Landzert. Essential to INTERNAL HERNIA. 101 the formation of such a hernia, according to Treitz, are: (1) The exis-tence of a fossa and its boundary fold; (2) the presence of the inferiormesenteric vein in the fold; (3) sufficient mobility of the small intestineto permit its entering the hernial sac. The average size of
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