. Manual of operative surgery. Freemans paperalready mentioned, to Moynihans work, Retroperitoneal Hernia, London, 1906, to Jon-nescos Hernies internes retro-peritoneales, Paris, 1890. Vautrin, Les Hernies Paraduo-denales, Rev. de Chir., Jan., 1907. Desjardins Mayo Clinics. 1917. 624 RETRO-PERITONEAL AND DIAPHRAGMATIC HERNIA ing colon as far as the right kidney, (c) Subcecal fossa. This fossa Hes be-neath the cascum and external to the meso-appendix and meso-ca;cum. Anyone of the pericaecal fossae may be the site of an internal hernia, especially if itsnormal relations have been altered by att
. Manual of operative surgery. Freemans paperalready mentioned, to Moynihans work, Retroperitoneal Hernia, London, 1906, to Jon-nescos Hernies internes retro-peritoneales, Paris, 1890. Vautrin, Les Hernies Paraduo-denales, Rev. de Chir., Jan., 1907. Desjardins Mayo Clinics. 1917. 624 RETRO-PERITONEAL AND DIAPHRAGMATIC HERNIA ing colon as far as the right kidney, (c) Subcecal fossa. This fossa Hes be-neath the cascum and external to the meso-appendix and meso-ca;cum. Anyone of the pericaecal fossae may be the site of an internal hernia, especially if itsnormal relations have been altered by attacks of appendicitis. The fossae arealso of surgical importance, as they may be filled with the products of inflamma-tion in appendicitis, and into one of them the appendix itself may be herniated,4. The intersigmoid fossa (Fig. 768). On the lower or left surface of themeso-sigmoid a fossa may exist which is variable in size. A few cases of herniahave been described in which this fossa formed the sac. Sigmoid tersigmoid fossa. 1^ Drs ending colon Ureter Fig. 768.—(Zuckerkandl.) Many operations have been undertaken for the treatment of obscure in-testinal obstruction, chronic or acute, and in many of these, symptomaticrecovery has ensued, although no cause was discovered during the in many of these cases an internal hernia has been overlooked orhas been reduced, unknown to the operator, by the manipulations necessaryin exploration. This short chapter has been written to direct the attention of the juniorsurgeon to the probable sites of internal herniae. The author believes thatinternal herniae are very much more common than statistics would indicate. LARGE HERNIA Occasionally herniae become so large and contain so many organs that theseorgans may be said to have lost their right of domicile in the abdomen, andhence reduction, whether operative or non-operative, becomes impossible orunjustifiable. In other cases adhesions uniting the hernial contents to ea
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