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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    been operated on on the same side ten months before, in St. Thomas's Hospital, and that a large quantity of omen- tum had been taken off. A case of right oblique inguinal hernia in a man aged 43. It belonged to the intermus- cular, or ascending variety, described by Mr. Luke, in the Medical Gazette of 1850. The tumour in this instance, instead of passing down into the scrotum, had mounted up in the cellular tissue between the external oblique ten- don and the internal obhque muscle, considerably above the level of the anterior superior spinous process of the ileum. On the free division of the tendon of the external obhque and the subjacent fascise, the sac was exposed ; it was drawn down, a free incision made into it, and the intestine exposed. This was highly inflamed ; no fur- ther impediment to reduction was found, strangulation having arisen in consequence of the peculiar position of the body of the hernia, and the bending upwards on itself of the bulk of the gut, a distinct indentation existing at the angle of fliexure. Strangulation had existed for four days, but the symptoms had not been severe till within fifteen hours of the operation. This man had used for a considerable time an ill-adjusted truss, which commanded the outer but not the inner ring. The protrusion had, in consequence of the resistance offered to its descent in the former locality, mounted upwards, and had thus become analogous to the upward course of a femoral protrusion, the truss having acted in the same way in the inguinal as the blending of the fascia transversalis below the saphe- c 2