Studies in the surgical anatomy of the small intestine and its mesentery : Mütter lecture delivered at the College of Physicians of Philadelphia, December 2, 1904 / George H. Monks.

  • Monks, George H. (George Howard), 1853-1933.
Date:
[1905]
Catalogue details

Licence: In copyright

Credit: Studies in the surgical anatomy of the small intestine and its mesentery : Mütter lecture delivered at the College of Physicians of Philadelphia, December 2, 1904 / George H. Monks. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    12/60 (page 6)
    THE DISTANCE TO WHICH DIFFERENT LOOPS OF THE INTESTINE MAY BE DRAWN DOWNWARD IN THE MEDIAN LINE. For the sake of determining roughly the relative mobility of the different parts of the small intestine in a downward direction, I made a number of measurements on cadavers. These measurements rather suggest the probability that it must be unusual for a loop in the upper part of the tube to occupy a position in the lower part of the abdomen or in the pelvis. Conversely, as I have ascertained by drawing loops from the lower part of the tube upward, it is probably also unusual for one in the lower part of the tube to occupy a region high up in the abdomen. This general rule, to which, however, there may be occasional and marked exceptions, is of use in giving us a certain amount of information as to what loops we are most apt to meet through an incision in one or the other of these two regions. Sixteen subjects in all were used, and in each subject a loop of intestine was drawn down at every foot, and the measurement taken. It was found more convenient and exact for purposes of comparison to take the measurements upward from the level of the pubic spine to the various loops as they were drawn downward one after another. The method used is shown in Fig. 2. The abdomen has been freely laid open from ensiform cartilage to pubes. Results.—Summarizing the results, I find that: (1) Taking the loops in succession, from above down- ward, each, as a rule, reached a little lower than the preceding one. (2) A loop from the first foot of the jejunum could, on the average, be drawn to a point about 3 inches (73/2 centi- metres) above the pubes. The extremes were 3^2 inch (ij4 centimetres) and 43/2 inches (113/2 centimetres). (3) In all but one of the subjects the pubes was reached by some part of the intestine. This usually did not occur be- fore the tenth foot of the canal had been brought down.