Atlas and epitome of abdominal hernias / by Dr. Georg Sultan.

  • Sultan, Georg.
Date:
1902
Catalogue details

Licence: Public Domain Mark

Credit: Atlas and epitome of abdominal hernias / by Dr. Georg Sultan. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    of the hernia it is highly probable that one and the same intestinal coil protrudes through the hernial orifice. The Omentum.—In 283 inguinal hernias, Maydl has found the omentum as the sole contents 77 times, and omentum together with the intestines 34 times; in 123 femoral hernias he found omentum alone 19 times, and in combination with the intestine 14 times. If both omen- tum and intestine are contained in the same hernia, the omentum usually retains its relative position and is situated in front of the intestinal coil. If the omentum remains in the sac for some time, it frequently undergoes certain changes. The opposed omental surfaces may grow together, forming irregular masses, or the fatty tissue of the omen- tum may take on a lipomatous thickening. Adhesions are very easily formed between the omentum and the wall of the sac, and it is usually the lowest tip of the omentum that grows fast to the sac. This is not always so, how- ever, since in some rare cases a certain portion of the sur- face of the omentum may adhere to the fundus of the sac and the free end turn upon itself and pass back into the abdominal cavity (Fig. 14). If such a condition is not recognized at the time of operation, the customary ligation of the omentum in sections may be followed by bad results, since such an omental process, being cut off from all of its connections, falls into the peritoneal cavity, becomes necrotic, and thus favors the development of a purulent peritonitis. The Large Intestine.—The sigmoid and the transverse colon possess rather long mesenteries, which are, how- ever, subject to great variations in this respect. The as- cending and the descending colon have no free mesentery;