An analysis of a fourth series of eighty-nine cases of intussusception / by W. McAdam Eccles and F.F. Laidlaw.

  • Eccles, William McAdam, 1867-1946.
Date:
[1912]
Catalogue details

Licence: In copyright

Credit: An analysis of a fourth series of eighty-nine cases of intussusception / by W. McAdam Eccles and F.F. Laidlaw. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    In one patient (No. 39) a gangrenous polypus was found in the caecum after this had been removed for an irreducible ileo- caecal intussusception, and in a second case (No. 79) an enteric intussusception was found to be due to the presence of a myxo-sarcoma. With regard to the view that errors of diet may play an important part in the etiology of the affection, an examination of a curve showing the age incidence is highly suggestive, with its very marked maximum occurring in the months from four to eight of the first year of life. In the case of some of these infants a vague history of indi- gestion or of some change in diet has been elicited (e.g. Nos. 2, 5, 3°> 3L 76). On the other hand, a number of cases occurred in infants who, according to the clinical notes, were entirely breast-fed. 3A. Variety of the Intussusception.—Of the 89 cases in the present series, 9 are enteric, or 10 per cent.; 5 are colic, or 5.6 per cent.; 40 are ileo-csecal, or 45 per cent.; 25 were ileo-colic, or 28 per cent. In 10 the variety was unknown, or is un- recorded. One which is included amongst the ileo-caecal was in reality appendicular. In relation to the classification of the varieties of the lesion, it is interesting to note that the late Mr. Barnard suggested the following:— 1. Enteric. 2. Entero-colic. ileo-caecal ileo-colic. caecal. iliaco-ileo-colic. appendicular. 3. Colic. Percentage rates of no cases at the London Hospital are given by him as :— Enteric . . . .9 per cent., 10 cases. Entero-colic . . .84 per cent., 92 cases. Colic . . . .7 per cent., 8 cases. Barnard, in speaking of the ileo-colic section, remarks that “growth takes place entirely at the expense of the entering layer,” and he held that an intussusception of this character originated as a prolapse of the ileum through the ileo-csecal valve, which stands fast whilst more and more ileum is pro- lapsed through its orifice into the cgecum. Fitzwilliams, on the other hand, takes the view that the apex