A memoir on strangulated hernia : from cases occurring in the London Hospital / by Nathaniel Ward.

  • Ward, Nathaniel, 1820-1866.
Date:
1854
Catalogue details

Licence: Public Domain Mark

Credit: A memoir on strangulated hernia : from cases occurring in the London Hospital / by Nathaniel Ward. 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.

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    the mucous membrane much congested, particularly that part which had been in contact with the inner boundary of the ring. This case is interesting as showing that when an omental hernia exists prior to the occurrence of an enterocele, the inflammatory action on the bowel is much limited in intensity. This circumstance arises from two conditions,—the first, the enlargement of the femoral ring by the presence of omentum ; the second, the pre- sence of the omentum between the sharp edge of Gimber- nat's ligament and the bowel, so that the sharpness of the former, and its consequent injurious action on the latter, are materially diminished, as in this instance, in which though the symptoms of strangulation had lasted about eight days, the mucous membrane had not ulcerated, nor had the bowel lost its lustre. This result strikingly con- trasts with the rapidity and severity of symptoms that usually supervene in a case of simple protrusion of the bowel (particularly in lean subjects), in which it is brought into almost immediate contact with Gimbernat's ligament, the mucous membrane frequently ulcerating through, even in the course of less than forty-eight hours after the descent. 4. A woman, aged 40, who had sufiered from symp- toms of severe strangulation six days before admission. The nature of her affection had been overlooked for that space of time, and a remarkably varied, and what is termed palliative, treatment had been adopted. The gut, when the operation was performed, was found mortified, and faecal matter was extravasated in the immediate