Peculiar form of spina bifida, with imperforation of the duodenum and rectum / by J.B.S. Jackson.

  • Jackson, J. B. S.
Date:
[1858?]
Catalogue details

Licence: Public Domain Mark

Credit: Peculiar form of spina bifida, with imperforation of the duodenum and rectum / by J.B.S. Jackson. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    fdijrP'S'j PECULIAR FORM OF SPINA BIFIDA, WITH IMPERFQRATION OF THE DUODENUM AND RECTUM. Z T^ [Communicated for the Boston Medical and SurgicarJojitaaVfipcrSa, *58.]> BY J. B. S. JACKSON, M.D. ^fe// I The subject of the above malformations was received a fcV^eeks \ ago from Dr. James W. Robbins, of Uxbridge; and in connection with the case, the following communication, essentially, was made J to the Boston Society for Medical Improvement. It was a new- born child, and born apparently at the full period; presenting by the arm, it was turned, and lived about half an hour after its birth. The mother had previously had three well-formed children. Externally, the penis was quite deficient, and the urethra termi- nated beneath it and at some distance from its extremity. Over the lower portion of the sacrum was a soft, fleshy excrescence, about half as large as a nutmeg, of a flattened form, and covered by healthy skin. Otherwise well. The stomach was quite large, and distended. The duodenum terminated in a perfect cul de sac just before the bile duct opened into it, and was distended to the size of a large nutmeg. The in- testine, proper, commenced almost at once, and was in no way re- markable except at its lower termination. The rectum opened into the bladder at its fundus, with which it was intimately con- nected; it then tapered off to a small extremity like an appendix cceci, this terminating portion being about three-fourths of an inch I in length, and standing off from the line of the bladder and rec- tum at a right angle. The bladder was exceedingly small; and the urethra so small, that though the bladder was once, and once only, inflated from it from without, several unsuccessful attempts were made to force air through it by inflating the bladder from the rectum. The right testicle was in the scrotum and the left in the abdomen. Something was also found which it was thought at the time (but erroneously, as the microscope afterward showed) might be an imperfectly developed third testicle, the vas deferens of which joined that of the left testicle about midway. Over the front of the sacrum were two thin, but firm, rounded, well-defined cysts, each one third of an inch or more in diameter; they lay side by fside, but the cavities did not communicate, nor were they connect- ed with the neighboring parts except by cellular tissue; these contained apparently a thin serous fluid. The left jugular and subclavian veins formed a trunk that passed down behind and in close connection with the left auricle, and opened into that upon the right side. Otherwise, nothing unusual was observed in the internal organs. The bladder was small, but the kidneys were about as large as usual. Cavity of the pelvis small. The cutaneous excrescence above referred to, though apparently a small affair, was quite interesting. On removing the surround- ing integuments from the parts beneath, a short, rounded, firm,