Some congenital malformations of the intestinal canal / by William Turner.

  • Turner, Wm. (William), Sir, 1832-1916.
Date:
[1863]
Catalogue details

Licence: Public Domain Mark

Credit: Some congenital malformations of the intestinal canal / by William Turner. 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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    • The large intestines were normal in their arrangement. Their diameter:was about twice that of the ileum and lower endK)f tlie jejunum'. The ilio-eoecal valve was well formed, and no obstrue- tion existed at its orifice. The biliary and pancreatic ducts opened in the usual way into the duodenum. Tlie jejunum, as far as the cul-de-sac, was distended with a dark brown liquid, which was prevented from passing any lower down, through the constriction already described. The coils of the small intestine contained a bluish-green slimy material, probably inspissated mucus. The valvulfB conniventes were small, the villi well developed.^ The large intestine contained a material not unlike that found in the lower end of the small. I may also mention that Dr Thorold noticed during the post-mortem examination that the spleen was subdivided into several distinct gland masses, situated partly at the cardiac end, and partly along the great curvature of the stomach. The chief interest of this case will, I think, rest in the determi- nation of the cause which produced the excessive atrophy I have described, for its position so high u.p the canal puts it beyond the reach of successful operative interference. To what circumstances, then, are we to ascribe this malformation. 1st, Was it produced by a simple diminution of formative power at this spot, during the evolution of the coils of the small intes- tine out of the single loop of which the canal is at first formed ? or, 2d, Was it due to a morbid process, probably inflammatory, set up at an early period of embryonic life, which produced a local or limited atrophy of the gut ? That the first named of these supposed causes may occasion atrophy of an organ, or part, is borne out by some of the cases which the records of pathology furnish us with. And such defi- ciencies in the development of a part especially occur in those localities in which a structure subservient only to the purposes of the foetal economy shrivels up and altogether or in part dis- appears. 1 may, in illustration of this statement, more especially refer to the numerous cases which have now been recorded,^ in which a contraction of the aorta, amounting in some instances to a complete closure, has been met with at or just below the termina- tion of the arch; localities which embryological research has taught us correspond in the one case to the place of junction of the fifth and fourth vascular arches, in the other to that of the right and left aortic roots. Now, in the natural development of the vessels, both the right aortic root and that part of the fifth leit arch which constitutes the ductus arteriosus atrophy and disappear either altogether or j)artially. And in the cases of contraction of the aorta liere referred to, the diminution of the calibre of this vessel seems to have been due to an extension to it of the same process ^ Sec an artido by Dr Peacock in tlic Medico Cliirnri^ical llcviow, 18G0 vol. XXV. p. 407 ; also iny Memoir on tiie Trregiilarities of the large Bloodvessels, in the same Jourual, October 1802, p. 406.