The Anatomy of the Intestinal Canal And Peritoneum in Man

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In this rupture, the small intestine was contained within a sac that formed a tumour to the left of the middle line, and that had been evidently deve- loped at the expense of the peritoneum leading to the descending colon.
There are three significant facts about this form of hernia that require notice. In the first place, the orifice of the sac was some way removed from the duodenal bend ; in the next place, the commencement of the jejunum was not involved in the rupture ; and thirdly, a branch
... of the inferior mesenteric artery ran along the free anterior margin of the orifice of the sac.
Now, Treitz and others have endeavoured to show that this form of hernia also is developed from the duodenal fossa. If such were the case, it is hard to understand why the orifice should become so much INTESTINAL CANAL AND PERITONEUM. 23 displaced, and why the commencement of the jejunum, that is theore- tically the first segment of the gut to enter the sac, should be entirely free of it. Treitz and his followers endeavour to explain this mesocolic hernia by asserting that the duodenal plica is often turned to the right, and its fossa to the left.


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