Clinical and pathological observations on acute abdominal diseases due to conditions of the alimentary tract and the uniformity of their origin : the Erasmus Wilson Lectures 1904 / by Edred M. Corner.

  • Corner, Edred M. (Edred Moss), 1872-
Date:
1904
Catalogue details

Licence: Public Domain Mark

Credit: Clinical and pathological observations on acute abdominal diseases due to conditions of the alimentary tract and the uniformity of their origin : the Erasmus Wilson Lectures 1904 / by Edred M. Corner. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

    30/112 (page 26)
    In two or three instances, whilst doing a herniotomy, the mesentery has been injured in the process. The bleeding vessels, once an artery of some size, and therefore of some importance, ligatured and the rent sutured. These cases did uniformly well. In one of them, in which the mesentery was noted to be loaded with fat, there was scarcely any bleeding. Thinking this over afterwards, it seemed that the vessels were thrombosed, so explaining the fact that no haemorrhage resulted from the tear. In all of these cases the rents were more or less perpendicular to the long axis of the bowel, the obliquity only involving a small length on a line parallel with the same axis. So that at the most, only half an inch of the bowel had its blood supply interfered with. The suggestion that, at least in the last case, the mesentery tore, and was not divided by the herniotomy knife, is strengthened by the following example, in which a previously thrombosed and fatty mesentery tore with the greatest ease. A woman, CM., aged 63, was admitted to St. Thomas' Hospital on July 27,1902. She had known of the presence of a right-sided femoral hernia for a year, and it had now been strangulated for thirteen hours. The pain and the vomiting had been very severe. At the operation, the sac contained a little bloody fluid and a loop of small intestine, which, though a little dark in colour, was obviously returnable. Gimbernat's ligament was incised, and gentle traction applied to the bowel. But try as one would, the mesentery kept separating from the intestine, and in spite of great care and a second and freer herniotomy, four and a half inches of bowel were denuded. There was no haemorrhage, the vessels being thrombosed. About a foot of the bowel was resected, and the ends united by a circular enterorraphy. A radical cure was then performed. Beyond the occurrence