Notice of the dissection of a case of lateral transposition of the viscera of the thorax and abdomen in a man / by Allen Thomson.

  • Thomson, Allen, 1809-1884.
Date:
[1853?]
Catalogue details

Licence: Public Domain Mark

Credit: Notice of the dissection of a case of lateral transposition of the viscera of the thorax and abdomen in a man / by Allen Thomson. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    heard under the right nipple, where its beat was also felt most distinctly. Although the altered position of the heart was detected, it was not before death ascertained to have arisen from malformation. The urgency of the symptoms, and the extent to which the disease had proceeded, probably precluded that minuter examination wliicli might have Ijeen made at an earlier period. Some mdema of the extremities had begun, and the patient was supposed to have died from the combined effects of disease of the lungs and heart; while the displacement of the heart was attributed probably to empyema on the left side, where the didness of sound, caused, as it appears, by the liver, was perceptible. The dissection of the body had proceeded some way, and the thorax was opened, when I perceived the nature of the case, from the position of the heart towards the right side, and the arch of the aorta passing over the root of the left lung; and, on opening the abdomen, I found that the malformation extended to that cavity. A muco-purulcnt effusion into the pulmonary tissue and bronchial tubes, and some degree of enlargement of the heart, were the only morbid appearances, relating to structure which were observed; and in all other respects, with the exception of the transposition, there was no deviation from the natural condition of the viscera. A lengthened detail of the dissection in tliis case is altogether unnecessary, and the accompanying drawing will indicate suffi- ciently clearly the general nature of the malformation. It might almost be described in the words of Isid. Geoff. St. Hilaire, as applied to the complete form of the transposition of the viscera, or, as he has termed it, splanchnic inversion—viz. that the non- symmetrical organs of the thorax and abdomen are placed precisely as they would be seen in an image of the natural ones reflected from a mirror. But in the case before us the inversion was not quite complete, the stomach, with some adjacent organs, having in _part retained their position on the left side. The heart pointed to the right side, and the arch of the aorta passed over the right side of the trachea and gullet, instead of the left. On opening the pericardium, the pulmonary ventricle and the systemic auricle were seen therefore to the left of the heart, with the vena cava superior on the left side descending into the latter cavity. The mam pulmonaiy artery, rising from the pul- monary ventricle, wound round tlie right side of the aorta, to pass below its arch. Three principal arteries similar to the usual ones, arose from the arch of the aorta, the first one being the mno- minata, dividing into the left carotid and subclavian arteries, w’hile the right carotid and right subclavian arteries^ arose sepa- rately, and in succession, from the arch of the aorta. Ihe remains of the ductus arteriosus joined the hollow' of the arch towards tlie