Some points in the anatomy, pathology, and surgery of intussusception . reventing or counteracting any undue dilatation ofthe vessels. In the most acute cases, however, where the pres- INTUSSUSCEPTION 17 sure at the neck of the intussusception has been so severe as tocut off the blood-supply, the capillaries may be empty. Nobleeding occurs in these cases, and the surgeon is sometimes mis-led as to the nature of the affection he is called upon to after the intussusception has been reduced, when the bloodagain passes through the empty vessels, it either escapes or somuch plasma exudes
Some points in the anatomy, pathology, and surgery of intussusception . reventing or counteracting any undue dilatation ofthe vessels. In the most acute cases, however, where the pres- INTUSSUSCEPTION 17 sure at the neck of the intussusception has been so severe as tocut off the blood-supply, the capillaries may be empty. Nobleeding occurs in these cases, and the surgeon is sometimes mis-led as to the nature of the affection he is called upon to after the intussusception has been reduced, when the bloodagain passes through the empty vessels, it either escapes or somuch plasma exudes as to cause a fresh oedema, which may besufiScient to paralyze the bowel and kill the patient. Paralysis ofthe bowel from haemorrhage is rare, and it is more often due tooedema of the circular muscle, for small extravasations of bloodmay be absorbed in simple cases, leaving the wall of the intestinethickened, but still capable of doing its duty. Later Changes.—Some of the later stages in an intussuscep-tion are seen in a section^ (Fig. 9j taken from the ceecum of a. Fig. 9.—Section through the csecum of a child, tet. 9 months, who died sixtyhours after the onset of symptoms (.John Hiiuters specimen). The mucousmembrane is almost unaffected, but it is covered with clotted blood. Themuscularis mucosfe is normal. The submucous layer is thickened. Thecircular layer of muscle is more (edematous than the longitudinal is thickened by threads of fibrin, and it contains a congestedlymphatic gland. boy, aged 9 months, who died sixty hours after the first symptomsof intestinal obstruction had been recognised. The specimen is ofgreat interest. It was shown by John Hunter on August 18,1789, at the Society for the Improvement of Medical and Chirur-gical Knowledge, one of the most select medical societies whichhas existed, for it consisted of twelve members, who met once amonth at Slaughters Coffee-House in St. Martins Lane. Persons^ Hunterian Museum, No. 2,703. 2 i
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