Intestinal obstruction : its varieties with their pathology, diagnosis, and treatment / by Frederick Treves.

  • Treves, Frederick, 1853-1923.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Intestinal obstruction : its varieties with their pathology, diagnosis, and treatment / by Frederick Treves. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    away from its original point of adhesion as to produce the band described. It must be remembered that not only may these Ijands form arcades beneath which coils of intestine may become strangulated, but the longer of them may become separated at one of their points of attachment, and so form floating cords that may lead to strangulation of a loop by knotting. Adhesions of all kinds, but especially those attached to parts not susceptible of much movement, may undergo considerable contraction. In cases of extensive peritonitis this contraction may produce great deformity. The mesentery may become so shrunken as to produce obstruction in the intestine to which it is attached. The most severe form of this condition is that known as peritonitis deformans. Adhesions upon the surface of a fixed part of the intestine may, as a result of their contraction, pro- duce great narrowing of the bowel by compressing it. This condition is not infrequently met with in the colon, and especially in the hepatic and splenic flexures (Fig. 22). In parts of the tube where the gut cannot be compressed against an unyielding surface the contraction of peritoneal adhesions may still produce some obstruction by causing an extensive puckering of the intestinal walls. Some of the adhesions formed after inflammation oJt the serous membrane are exceedingly complicated, while others are found to unite parts that are usually far separated from one another. Thus I find in- stances of adhesion between the ascending colon and the ovary, between the transverse colon and the csecum in one case, and the mesentery over the lower lumbar region ii^ another, between the arch of the colon and a part of the parietes not far above the symphysis. Then again the sigmoid flexure has been found connected by adhesions to the bladder, the