On retro-peritoneal hernia : being the 'Arris and Gale' lectures on the 'The anatomy and surgery of the peritoneal fossae' : delivered at the Royal College of Surgeons of England in 1897 / by B.G.A. Moynihan.

  • Moynihan, Berkeley Moynihan, Baron, 1865-1936.
Date:
1906
Catalogue details

Licence: Public Domain Mark

Credit: On retro-peritoneal hernia : being the 'Arris and Gale' lectures on the 'The anatomy and surgery of the peritoneal fossae' : delivered at the Royal College of Surgeons of England in 1897 / by B.G.A. Moynihan. 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.

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    behind the caecum and ascending colon. The ascending colon had an immensely long mesentery. The strangled gut was withdrawn and the patient made a good recovery. Case of Mansell Moullin.1—Male, forty years of age, was suddenly seized with griping pain in the epigastrium ; vomiting set in on the following day and continued. On admission on the fourth day, he complained of pain chiefly in the right iliac fossa ; pulse 98, tongue dirty and dry. The abdomen was moderately distended. Except in the right iliac fossa, it was soft and resonant on percussion. It was sensitive to pressure, but was not tender. In the right iliac fossa there was more resistance, and on palpation a fairly well-defined swelling could be felt, rounded above and not reaching higher than the umbilicus. Per rectum there was a soft bulging mass in front and on the right side. There was no vomiting on the day of admission, and the bowels acted twice after enemata, though the motions were small. The patient stated that he had suffered from four previous attacks of a similar character which had subsided in three or four days. A diagnosis of appendicitis was made. ' On opening the abdomen, the surface of the intestine was seen to be reddened and to have lost its polish, but there was no lymph or pus. The distension was only moderate in degree. On passing the finger down towards the caecum, a ring was felt around some intestine. It passed inwards towards the middle line and slightly downwTards. The finger- nail passed easily underneath it and at once some brownish offensive fluid, similar in appearance to that which he had vomited on the last occasion, began to escape. ' The general peritoneal cavity was then packed off with iodoform gauze, a drainage-tube passed close to the opening, and the wound left widely open. ' The patient died the same day. At the post-mortem examination, a loop of the ileum was found lying in a sac behind the caecum, communicating with the general peritoneal cavity by an opening a little more than an inch in diameter. 1 Lance/, April 1, 1899.