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

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 Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    intestine to points upon the parietes are persistently dragged npon. It follows from this almost constant tension that the still soft adhesion yields, becomes elongated and thinned, ultimately gives way and is absorbed. Movement also has great influence upon the future physical characters of the adhesion. Most of the adhesions assume primarily a membranous cha- racter, and this they may retain throughout their existence. It is not uncommon to find some coils of intestine matted together by an extensive series of false membi-anes, which appear sometimes as wide expansions, at other times as thin but broad ribbon- like bands, of all dimensions and of various lengths (Figs. 1 and 24). If two distant coils of small intes- tine have been brought together during peritonitis, and have become attached to one another by means of the exudation, or if a like attachment has taken place between the intestine and the parietes, then, as move- ment is restored in the bowel, the adhesions, which may be quite membranous, are dragged upon, and as a result become elongated. As they increase in length so must they become attenuated in width and thickness. The constant tension, moreover, probably interferes with their already feeble nutrition, and induces a further wasting. The wide membranous adhesion may thus become narrowed and ribbon-like. It may, however, undergo a still further change This adhesion, subjected to the rolling movements''of the intestines over one another, and subjected to fre- quent tortion, now in one direction and now in the other, tends to become rounded and cord-like, and the more that it is stretched the more completely is this transformation favoured. Thus are formed peritoneal false ligaments and the bands that are 80 common a cause of strangulation of the bowel.