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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    in the left liypochondriac region, below the larger part of tiie liver and gall bladder; but as the gullet passed tlirough its usual place, near the middle of the back part of the diaphragm, the cardiac portion of the stomach was much drawn up, first below and next behind the smaller part of the liver, while the body of the organ lay lower do^vn than the liver, in the left hypochondriac and lumbar regions, and the pyloric portion stretched from this for- ward, and downwards towards the middle of the abdomen. Here, or a little to the left of the midtUe line, it joined the duodenum, which was raised from its usual deep situation, but otherwise nearly in its natural place, being directed towards the right, then curving do\vnwards, and lastly, joining a portion of intestine which crossed the middle line towards the left, and making a sudden turn back to the right, passed behind the mesenteric vessels to terminate in the part ol intestine corresponding to the commence- mentof the jejimum on the right side. This portion, directed towards the left, could not be regarded as the duodenum transposed; for it was not attached to the pancreas, and was rather to be looked upon as a portion of the jejunum drawn out of its place. On the part of intestine which has just been described, as intervening between the duodenimi and the transposed jejimum, and which might be considered as a part of the latter drawm out of its usual relations, a small diverticulum existed, about an inch and a half in length and width, and of a rounded sacculated shape. It is worthy of remark, that this diverticulum was precisely in the situation in which we might expect it to be found, supposing it to arise in connexion with the remains of the ductus vit^o- intestlnalis of earher foetal life, and was held foiward to the ab- dominal parietes by peritoneal adhesions. Tlie spleen was attached as usual to the great ciuvature of tlie stomach, and placed along with it lower than it usually is under the liver in the left hypocEondrium. The pancreas was placed as usual wltli its larger end in the lioUow of the duodenal curve, and extended thence towards the spleen, its position departing only slightly from that of tlie natural organ, in consequence of the deviation of the duodenum. Tlie kidneys were naturally placed, excepting that the left was somewhat the lower of the two. I regret that the existence of complicated adhesions between the abdominal and visceral peritoneum in the idcinity of the duodenum, which matted together several of these parts, pre- vented me fi'om ascertaining with precision the state of the foramen of Winslow, and of the lesser cavity of the peritoneum, together ivith the attachments of the great omentum, as 1 thought that considerable interest might have attached to the examination of these parts, had they not been so obscured, more especially in connexion with the modification in this case of that process of folding by which the colon, originally straight and nearly sym-