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Epigastric hernia Stock Photos and Images
RFM8RCNX–An epigastric hernia. intestinal hernia. Infographics. Vector illustration on isolated background
RFFTJH4P–Hernia - Medical Report with Composition of Medicaments - Pills, Injections and Syringe. Diagnosis - Hernia On Background of Med
RF2WJ6FN0–Illustration showing Gastrophageal reflux disease (GERD) is a digestive disorder where stomach acid flows back into the esophagus, causing discomfort
RFHPF74J–Medical Concept: Hernia Handwritten on Black Chalkboard. Top View of Blue Stethoscope on Chalkboard. Black Chalkboard with Hernia - Medical Concept. 3
RF2PJ669F–Gastroesophageal reflux disease. GERD. Cross section of human stomach. Normal internal organ and stomach with Acid reflux. Vector illustration
RM2AKMP9M–Modern surgery, general and operative . uinal regions. A ven-tral hernia may be median {herniaof the linea alba) or lateral. Thetreatment is radical operation.Epigastric hernia is a form of ventral hernia. In this condition there isa protrusion of the peritoneum in the space bounded by the ensiform cartilage,the ribs, and the umbilicus. The sac of peritoneum may be empty, maycontain omentimi, or omentum and bowel. The stomach very rarely passesinto the sac. The protrusion is usually, but not invariably, through the lineaalba. The condition may be due to a congenital gap in the transversalisfas
RF2WJ6FN2–Illustration showing Gastrophageal reflux disease (GERD) is a digestive disorder where stomach acid flows back into the esophagus, causing discomfort
RM2CD9RWJ–. Physical diagnosis . person past middle life, is hard and nodular, and does notdisappear after catharsis, it is almost invariably due to cancer of thestomach. Such a tumor may also be due to a mass of adhesions abouta gastric ulcer. Tumors of the pancreas much less often reach thesurface in this region; tumors of the liver are generally larger, andtheir connection with this organ can generally be demonstrated bypercussion, palpation, and by their greater respiratory mobility whencompared with gastric cancer. 350 THE STOMACH, LIVER, AND PANCREAS 351 Epigastric hernia usually shows an impulse
RM2AG77CG–. Modern surgery, general and operative. e(Fig. 841). Care must be taken in passing certain of them to avoid injuringthe deep epigastric vessels. When these stitches are tied, the femoral canalis obliterated. The flap of fascia lata is sutured to the aponeurosis of the ex-ternal oblique, and the skin is sutured. The best operation is that of Moschcowitz by the inguinal route. It givesa thorough exposure of the parts and enables the surgeon absolutely to close thefemoral ring. The incision is hke that for inguinal hernia except that it morenearly reaches the pubic region. The aponeurosis of the
RM2AWDYW5–Operative surgery . ons. If theseat of the constriction be at the internal ring it should be divided upwardand outward to avoid the epigastric artery (Fig. 1114, c) which runs along 908 OPERATIVE SURGERY. its iuuer border (Fig. 1115). In fact, in the oblique variety the incisionupward and outward is always to be made irrespective of the situation of theconstriction. The only fallacy that may arise is that of mistaking the directfor the indirect form of hernia. In recent and in congenital cases thismistake can hardly occur, but in those of longer standing, especially inacquired oblique hernia,
RM2AFX2F7–. The anatomy and surgical treatment of abdominal hernia. e lower part of the spine is shown. In this truss nocircular or thigh strap are required. Fig. 4. Salmon and Odys truss divested of its covering to show its balland socket apparatus, and the contrivance by which thespring can be lengthened or shortened at pleasure. Fig. 5. Represents the two apertures through which an oblique herniadescends, and the situation of the epigastric artery; belowPouparts ligament on the left side, is pointed out the part onwhich a truss should be applied for a femoral hernia. Fig. 6. Oblique hernia passing th
RM2AWDY5X–Operative surgery . Femoral artery, h. Femoral vein. i. Sheath of femoral vessels, j. Saphenous vein. the stricture be divided agreeably to directions often given—parallel withthe course of the epigastric vessels—or even upward or slightly outward,these vessels will be in danger of injury. If, on the other hand, the protrusion be of the direct variety, and theincision be made upward and outward, under the impression that it is a dis-placed indirect form of hernia, the epigastric vessels will then be exposed toperil (Fig. 1116). It is readily seen, therefore, that great caution should beemploye
RM2AFX694–. The anatomy and surgical treatment of abdominal hernia. ansversalis, and by the epigastric artery,A portion of the fascia is fixed in the pubes, and another part of itpasses behind Pouparts ligament to unite with the femoral ves-sels. r. The place at which the spermatic cord goes into the abdomen. The fascia situated on its outer side and lower part, is of consi-derable density, but becoming thin upon its inner side, so as toshow the epigastric artery and vein behind it; from the edge ofthe fascia a thin layer is sent off which unites itself to the sper-matic cord, which fascia in this disse
RM2AKMBW8–The science and art of surgery : being a treatise on surgical injuries, diseases, and operations . s occasionally happens in the oblique. The epigastric arteryalso is on the outer side, but usuall^^ arches very distinctly over the neckof the sac, sometimes indeed completely encircling the upper as well asthe outer margin (Fig. 682). Incomplete or Interstitial Hernia is usually of the oblique kind ;but Lawrence has observed that it may be of the direct variety. Itoften escapes notice, but may not unfrequently be observed on the op-posite side to an ordinary inguinal hernia. Double Inguinal Hern
RM2AFWW3W–. The anatomy and surgical treatment of abdominal hernia. them to the edge of the crural sheath.k. Internal abdominal ring, or upper aperture of the inguinal canal./. Spermatic cord passing through that aperture. m. External iliac artery.n. External iliac vein.o. Epigastric artery and vein.p. Third insertion of the external oblique into the pubes, covered, however, by the fascia transversalis.q. The space by which the crural hernia descends, the finger having passed into it before the drawing was made to push down the fascia which extends over it.r. The thyroideal foramen. Fig. 3. An anterior
RM2AG73WX–. Modern surgery, general and operative. t common in women. It is the catching of a por-tion of the circumference of the bowel, usually a portion of the lower part ofthe ileum. It is usually femoral, but may be inguinal, and even epigastric orobturator. It arises usually in an old, reducible hernia (Royal Hamilton Fowler,Am. Jour. Surg., Jan., 1912). Some cases are due to adhesions. It maybe due to truss pressure on an incompletely reduced hernia (Fowler, Ibid.).Strangulation of a partial enterocele may not completely close the lumen of thegut. There may not be stercoraceous vomiting or absolu
RM2AWK6R1–The practice of surgery . -, these congenital hernise donot persist beyond infancy, and it is interesting to note that of adults. Fig. 104.—Anterior abdominal wall, viewed from behind, showing the peritonealfossae: A, Obliterated urachus: B, fold of deep epigastric artery-; C, obliteratedhypogastric arteries: D, fossa at the internal abdominal ring; E, fossa behind theexternal abdominal ring i Campbell, adapted from Sobotta). suffering from hernia, but 5 or 6 per cent, will be found to have con-genital hernise. This protrusion may occur after the person hasreached adult life, even though the d
RM2AXGGRA–Lectures on the American eclectic system of surgery . blade is passed up flat-wise (see figure 139) along the finger andpushed on through the stricture. Its edge is then turned OPERATION FOR STRANGULATED HERNIA. 761 Fig. 139.. upward, cutting no more than necessary to admit the finger. The cut must, in all cases, be made directly Upward, parallel to the linea alba, whether it be in Direct or Oblique Inguinal Hernia, so as to avoid the epigastric artery. If there be no stricture in the neck of the sac, one may be found in the body. The stricture being thus relieved, and sufficiently dilated wit
RM2AFX1C9–. The anatomy and surgical treatment of abdominal hernia. J. J^Fr^rLck,. del Siru2az7-s Xiuh- In PLATE VIIL—Fig. 1. On the right side is seen an oblique inguinal hernial sac upon the ante-rior part of the spermatic cord. On the outer side of this hernia appearsan artificial anus, formed from a second protrusion of intestine on the sideof the former: at this opening the ileum had prolapsed, but in making thepreparation it was returned into the abdomen. Both these hernia? hadpassed through the abdominal ring, and were situated on the outer side ofthe epigastric artery, which has an unusual curve
RM2ANE7F4–A text-book of clinical anatomy : for students and practitioners . IJ> Fig. 77.—Coverings of inguinal (congenital and acquired) and of femoral hernias.(Diagrammatic.) DE, Deep epigastric artery. IC, Internal abdominal ring. E, Ex-ternal abdominal ring. F, Interior of both inguinal hernial sacs. IF, Infundibuliformfascia. CR, Cremasteric fascia. EO, Intercolumnar fascia (external spermatic) fromexternal oblique. SPC, Spermatic cord, lying on outer side of and behind sac. TV,Tunica vaginalis, not seen on opposite side because there is none in a congenital hernia, asshown on right side. A, Fem
RM2AKMBJX–The science and art of surgery : being a treatise on surgical injuries, diseases, and operations . Fig. 6S2.—Double Direct Inguinal Heraia: Neck of Fig. 6S3.—Double laguiual Her- Sac crossed by Epigastric Artery. nia on the same side: Oblique above, Direct below; separatedby Epigastric Vessels. Signs—The signs of inguinal hernia vary somewhat according toits character, whether inter.stitial, complete, or scrotal, oblique or direct.In the iiiterslilial hernia, a degree of fulness will be perceived in thecanal when the patient stands or coughs; and, on pressing the finger onthe internal ring, or
RM2AFWRKP–. The anatomy and surgical treatment of abdominal hernia. physis pubis. b. Spinous process of the ilium.cc. Abdominal muscles. d. The crural arch, or Pouparts ligament. e. Semilunar edge of the fascia lata. ./. Tendon of the external oblique cut open. g. Internal oblique and transversalis. h. External portion of the fascia transversalis. i. Internal portion of the same fascia. k. Internal abdominal ring. /. External abdominal ring. m m. Spermatic cord passing through both apertures to the testis. n. Testis. o. Epigastric artery. p. Cremaster muscle. q. Crural hernia.r. The sac of the crural he
RM2AFX0H1–. The anatomy and surgical treatment of abdominal hernia. its side placed towards the sac; itsedge is to be turned forwards to divide the ring. Fig. 6. Hernia on the inner side of the epigastric artery. a. Abdominal ring. b. Pouparts ligament. c. Femoral artery. d. Epigastric artery. e. Internal oblique and transverse muscles passing over the sac. /. Tendon of the transverse muscle passing under it. g. Fascia from Pouparts ligament, from which the cord hasbeen withdrawn to show the place through which itpasses. h. Hernial sac. i. Hernial sac above the ring. k. Knife introduced to show the mann
RM2ANE737–A text-book of clinical anatomy : for students and practitioners . Fig. 78.—Location of various forms of abdominal hernia; (diagrammatic). U,Umbilical hernia. D, Direct inguinal hernia. B, Indirect incomplete inguinal hernia.O, Complete or scrotal inguinal hernia. F, Femoral hernia. 241. - *.-*¥& Fig. 79.—View of inner aspect of anterior wall of abdomen to show internal orifices ofinguinal, femoral,, and obturator hernias. DA, Deep epigastric artery. E, Middle in-guinal fossa, corresponding externally to external abdominal ring. A direct inguinalhernia passes directly outward through this de
RM2AFWM92–. The anatomy and surgical treatment of abdominal hernia. IT French, del. inndalrs Llth EXPLANATION OF PLATE XIX. 413 q. Common trunk of the epigastric and obturator arteries. r. Obturator artery passing before and on the inner side ofthe neck of the sac, in its course to the obturator fora-men, and situated a little above the posterior edge of theexternal oblique muscle. s. Epigastric artery. An engraving of this preparation has been published in an in-genious Thesis on Crural Hernia, by Dr. James Sanders, Edin-burgh, 1805. PLATE XX. Shows three umbilical herniae, one of which is curious on a
RM2AFX1R2–. The anatomy and surgical treatment of abdominal hernia. on the opposite side. EXPLANATION OF PLATE VII.-%2. An internal view of the same preparation showing the orifice of thehernial sacs, with the relative situations of the epigastric and spermaticvessels. a. Symphysis pubis. b. Anterior superior spinous process of the ilium, c. The spine.d d d d. Abdominal muscles drawn downwards to show the cavity of the pelvis. e. The bladder. f. The rectum. g. Bifurcation of the aorta.h. The inferior cava.i i. Spermatic arteries.k k. Spermatic veins.I. Vas deferens.m m. Epigastric arteries and veins.n n
RM2AFX4E3–. The anatomy and surgical treatment of abdominal hernia. e. gg. The kidneys. h h. Aorta. i i. Iliac arteries. k k. Epigastric arteries, arising from the iliac arteries, and passing be-tween the mouths of the hernial sacs and the symphysis pubis,but still near to the inner side of the mouth of each sac. //. Spermatic arteries, arising from the aorta, and passing out of the abdomen behind the hernial sacs. m m. Inferior cava. n. Iliac vein. o o. Epigastric veins accompanying the epigastric arteries. q q. Spermatic veins, arising upon the right side from the inferiorcava, on the left, from the e
RM2AWDYGR–Operative surgery . Fig. 1113. Fig. 1114. Fig. 1113.—Indirect or oblique inguinal hernia, omental and intestinal contents, a,a. Integument and superficial fascia, h. Aponeurosis of external oblique muscle, c. Fascia transversalis. d. Sac of hernia, e. Omentum. /. Intestine.Fig. 1114.—The anatomy of inguinal and femoral regions, showing course of descent of indirect or oblique inguinal hernia, o. Divided borders of abdominal muscles, b. Transversalis fascia, c. Deep epigastric vessels, d. Aponeurosis of external oblique muscle, e. Fascia lata. /. Spermatic cord. g. Femoral artery, h. Femoral ve
RM2AFWY0A–. The anatomy and surgical treatment of abdominal hernia. ine of the bladder within the abdominal ca-vity.e. Testis. 388 EXPLANATION OF PLATE XL Fig. 6. Shows Fig. 5 more completely dissected.a. Neck of the hernial or peritoneal sac.b b. Hernial sac cut open as in Fig. 5. c. Aperture of communication between the protruded portion of bladder and that within the abdomen; the bladder being inthis view cut open. d. Interior of the bladder exposed. e. Epigastric artery, taking the same course as in oblique ingui- nal hernia of the common kind./. Abdominal muscles. Pig. 7. An outline, explaining the
RM2AFWYN1–. The anatomy and surgical treatment of abdominal hernia. 4. Represents the division of the epigastric artery, in a case of stran-gulated oblique inguinal hernia.—The preparation wassent to me by Mr. Lawrence. a. Spine of the iliumv b. Pubes. c. Rectus muscle. d. Mouth of the hernial sac. e. Extremities of the divided epigastric artery.f. Femoral vessels.—See cases. 49 386 EXPLANATION OF PLATE X. Fig. 5. Exhibits intestine strangulated by omentum.a a. Congenital hernial sac cut open.b b. Omentum adhering to the bottom of the sac. c. Bougie passed under the constricting band of omentum. d. Inte
RM2AFWX5F–. The anatomy and surgical treatment of abdominal hernia. liaca. k. Femoral sheath. 7. Femoral artery. m. Femoral vein. n. Saphsena major vein. o. Anterior crural nerve. p. Fascia lata turned back. q. Tendon of the external oblique muscle, drawn down. Fig. 4. Posterior view of the place at which the crural hernia descends,as it appears when the peritoneum is first stripped off. a. Pubes. b. Abdominal muscles. c. Round ligament passing into the inner abdominal ring. d. Femoral artery. e. Femoral vein. /. Epigastric artery. g. Epigastric vein. h. Depression at which the crural hernia first desce
RM2AFWR69–. The anatomy and surgical treatment of abdominal hernia. ?X 7*FreneA,, t£eZ StftcZcLLTS XtOt- EXPLANATION OF PLATE XVL 405 Fig= 3. Posterior view of figure 1. a. Symphysis pubis. b. Spinous process of the ilium. c. Ilium cut through. d d d. Rectus and other abdominal muscles, e. Linea semilunaris. /. Posterior edge of the crural arch. g. Fascia iliaca. h. The iliacus internus muscle. i i. Fascia transversalis. k. Internal abdominal ring. Z. Spermatic cord passing through the internal ring. m. External iliac artery. n. External iliac vein, o. Epigastric artery and vein. p. Sac of crural hernia
RM2CF319H–. Abdominal hernia : its diagnosis and treatment. , or it can be ascertained that the protrusionis actually extra-peritoneal, and it can be tlealt with accord-ingly. If the sac cannot be readily lifted from its posteriorattachments it should be suspected at once that it is eithersigmoid, csecal, or bladder hernia. When the finger is withinthe peritoneum, the anterior sac wall may then be carefully cutupon it with blunt scissors, care being exercised to avoidintestinal adhesions that may be present, and remembering theimmediate proximity of the epigastric artery. The contents ofthe sac mav then
RM2CEE291–. The anatomy and surgical treatment of hernia. danger to the blood-vessels andintestine, is generally maintained by introducing the knife into the middle part of thehernial sac, anteriorly, and dividing the stricture from below upward and inward inthe direction of the umbilicus. If this course is pursued, the line of the incision willbe quite parallel to the inner side of the epigastric artery, and althoCigh the division isa little deeper than if carried more externally, it does not seriously increase the com-plication of the operation by the enveloping folds of the intestinal loop, which may
RM2CEEF7D–. The anatomy and surgical treatment of hernia. S&if^^ INGUINAL HERNIA. ANATOMY OF THE PARTS INVOLVED. 33 The Epigastric Artery.—An accurate knowledge of the course of the epigastricartery is essential in operations for hernia, since it is situated so near the spermatic cord.This vessel arises from the iliac artery, behind Pouparts ligament, and passes upwardand inward close to the under and inner side of the cord, between it and the symphysis.Here it gives off a branch to the cord. For nearly two inches of its course it lies pos-terior to all the abdominal muscles, beneath the peritonaeum.
RM2CEEGPP–. The anatomy and surgical treatment of hernia. ternal oblique muscle, and that, by thus dragging these fibers along with them intheir descent, a series of inverted loops are formed by the gradual displacement andelongation of their intermediate and more movable portion.* The cremaster branch of the epigastric artery furnishes the blood-supply to themuscle, and the principal division of the external spermatic nerve is distributed toits fibers. This muscle is generally wanting in the female, yet the lower fibers ofthe internal oblique muscle are, in some instances, loosely distributed over the
RM2CEDKDC–. The anatomy and surgical treatment of hernia. Fig. 31.—Inguinal hernia, showing the transversalis fascia and the internal abdominal ring.—GRAY.Fig. 32.—Inguinal hernia, showing the internal oblique and cremaster muscles and spermatic cord.—Gray. In the dissection for the exposure of the parts, it is well to remember that thereis a superficial artery of some size—the external epigastric—which courses across theparts in the neighborhood of the external ring. This is sometimes of such a consider-able size that it misleads the inexperienced operator into the belief that the larger epi-gastric ve
RM2CF5DAR–. Abdominal hernia : its diagnosis and treatment. similar to scrotal hernia in the male. body without much tendency to follow the cord (figs. 21 and22). Coming out to the inner side of the deep epigastric artery,it protrudes directly through the external abdominal ring. Thecord is at its outer side from the median line, and its coveringof intercolumnar fascia prevents its descent into the scrotum.When small, it can usually be easily reduced by the pressure ofthe hand with the patient standing. Its diagnosis is attended7 98 ABDOMINAL HERNIA. by less difficulty than in the oblique, but the diffi
RM2CEY8F1–. Abdominal hernia : its diagnosis and treatment. ibly drawn down while being ligated and cut ava. This after e.amining its interiorto see that no adhesions exist. finally ligated and cut oflf it will retract within the abdominalcavity, leaving the femoral canal free of foreign tissue. Thisis absolutely essential to the subsequent permanent cure of thecase. It must be borne in mind that extreme traction mighteasily bring into the operative field either an angle of the blad-der wall to the inner side, or the deep epigastric vessels uponthe upper surface of the sac. Both of these have been se
RM2CEE87J–. The anatomy and surgical treatment of hernia. ior edge of Pouparts ligament on the outer side, and carried toward the median lineto emerge from behind forward through the thick aponeurosis of the fascia transver-salis, with which often fibers of the transversalis muscle are blended, care being takennot to wound the epigastric artery. The needle is then unthreaded, threaded with theopposite end of the suture, and withdrawn. Stitches are repeated in this manner,about one third of an inch apart, until the internal inguinal ring is closed from belowupward upon the cord, which is thus restored to
![. Anatomy, descriptive and surgical. ia. Saphenous opening closed by theCribriform fascia. ] INGUINAL HERNIA. Inguinal Hernia is that form of protrusion which makes its way through theabdomen in the inguinal region. There are two principal varieties of inguinal hernia—external or oblique, andinternal or direct. 998 SURGICAL ANATOMY OF INGUINAL HERNIA, External or oblique inguinal hernia, the more frequent of the two, takes the sameoblique course as the spermatic cord. It is called external, from the neck of the sacbeing on the outer or iliac side of the epigastric artery. Internal or direct iv Stock Photo](https://c8.alamy.com/comp/2CENNP7/anatomy-descriptive-and-surgical-ia-saphenous-opening-closed-by-thecribriform-fascia-inguinal-hernia-inguinal-hernia-is-that-form-of-protrusion-which-makes-its-way-through-theabdomen-in-the-inguinal-region-there-are-two-principal-varieties-of-inguinal-herniaexternal-or-oblique-andinternal-or-direct-998-surgical-anatomy-of-inguinal-hernia-external-or-oblique-inguinal-hernia-the-more-frequent-of-the-two-takes-the-sameoblique-course-as-the-spermatic-cord-it-is-called-external-from-the-neck-of-the-sacbeing-on-the-outer-or-iliac-side-of-the-epigastric-artery-internal-or-direct-iv-2CENNP7.jpg ". Anatomy, descriptive and surgical. ia. Saphenous opening closed by theCribriform fascia. ] INGUINAL HERNIA. Inguinal Hernia is that form of protrusion which makes its way through theabdomen in the inguinal region. There are two principal varieties of inguinal hernia—external or oblique, andinternal or direct. 998 SURGICAL ANATOMY OF INGUINAL HERNIA, External or oblique inguinal hernia, the more frequent of the two, takes the sameoblique course as the spermatic cord. It is called external, from the neck of the sacbeing on the outer or iliac side of the epigastric artery. Internal or direct iv Stock Photo")
RM2CENNP7–. Anatomy, descriptive and surgical. ia. Saphenous opening closed by theCribriform fascia. ] INGUINAL HERNIA. Inguinal Hernia is that form of protrusion which makes its way through theabdomen in the inguinal region. There are two principal varieties of inguinal hernia—external or oblique, andinternal or direct. 998 SURGICAL ANATOMY OF INGUINAL HERNIA, External or oblique inguinal hernia, the more frequent of the two, takes the sameoblique course as the spermatic cord. It is called external, from the neck of the sacbeing on the outer or iliac side of the epigastric artery. Internal or direct iv
RM2CEDKCF–. The anatomy and surgical treatment of hernia. Fig. 31. Fig. 32. Fig. 31.—Inguinal hernia, showing the transversalis fascia and the internal abdominal ring.—GRAY.Fig. 32.—Inguinal hernia, showing the internal oblique and cremaster muscles and spermatic cord.—Gray. In the dissection for the exposure of the parts, it is well to remember that thereis a superficial artery of some size—the external epigastric—which courses across theparts in the neighborhood of the external ring. This is sometimes of such a consider-able size that it misleads the inexperienced operator into the belief that the lar
RM2CEEBKE–. The anatomy and surgical treatment of hernia. es;and one on each side is situated between the remains of the umbilical arteries and the pubes. Theypassed between the tendinous fibers of the transversalis, which they had separated, and entered theabdominal rings, after which they were covered, as usual, by the fascia, which is extended from theexternal oblique muscle over the spermatic cords. a. Situation of the symphysis pubis. h, i. Two hernial sacs on the left side, formed b. The muscle removed from the anterior su- between the epigastric and umbilical arteries,perior spinous process of th
RM2CF5KCT–. Abdominal hernia : its diagnosis and treatment. ficial epigastric artery. Both are in deep layer of superficialfascia and are divided in hernia operations. 3, Circumflex iliac artery. Not usually divided. of the patient. In operating it will happen many times thatthe dividing line between the two layers is not discovered, butoccasionally it is so well defined as to mislead the operatorinto the belief that he has already reached the aponeurosis ofthe external oblique muscle. The only surgical importanceconnected with this fascia is that the deep layer contains twosets of vessels that are usua
RM2CJ45XX–. The principles and practice of modern surgery . ame as those of the oblique variety, except the cre-master, for it has no connexion with the cord. The epigastric artery runsexternal to the neck of the sac. This hernia may, however, push the con-joined tendon before it, instead of bursting through it. The spermaticcord generally lies on its outer side. 3. The congenital hernia is a variety of the oblique, and is so calledbecause that state of parts which permits of it only exists at or soon afterbirth. A portion of omentum or intestine accompanies the testicle in itsdescent, and passes down w
RM2CEECCT–. The anatomy and surgical treatment of hernia. inguinal hernial sac upon the anterior part of the sper-matic cord. On the outer side of this hernia appears an artificial anus, formed from a secondprotrusion of intestine on the side of the former: at this opening the ileum had prolapsed, butin making the preparation it was returned into the abdomen. Both these hernise had passedthrough the abdominal ring, and were situated on the outer side of the epigastric artery, whichhas an unusual curve, produced by the long-continued pressure of the hernia. On the left sidea hernial sac is seen, which ha
RM2CJ43G8–. The principles and practice of modern surgery . hernia of the right side. + This kind of hernia was first described by Hey of Leeds, in a letter to Gooch. INGUINAL HERNIA. 439 which, like the preceding, was copied from a preparation in the KingsCollege Museum, shows another variety of this hernia, in which the sac isapparently formed of tunica vaginalis, but its communication with the tes-ticle is closed. Diagnosis.—(1.) The difference between the oblique and direct inguinalkernics, and their relations to the epigastric artery, are shown in fig. 137,which is taken from Tiedemann. In the obli
![. Hernia, strangulated and reducible. With cure by subcutaneous injections, together with sugcested [!] and improved methods for kelotomy. Also an appendix giving a short account of various new surgical instruments. striangle and passes through the external ring. Hesselbachs triangle is situated at the lower part of theabdominal wall on either side. Its boundaries are: Externally.—Epigastric artery. Internally.—Outer margin of rectus. Below.—Pouparts ligament. The following are the coverings of the two varieties ofinguinal Hernia, commencing at the surface: o Oblique. Direct. 1- Skin. 1. Skin. Stock Photo](https://c8.alamy.com/comp/2CEDBW5/hernia-strangulated-and-reducible-with-cure-by-subcutaneous-injections-together-with-sugcested-!-and-improved-methods-for-kelotomy-also-an-appendix-giving-a-short-account-of-various-new-surgical-instruments-striangle-and-passes-through-the-external-ring-hesselbachs-triangle-is-situated-at-the-lower-part-of-theabdominal-wall-on-either-side-its-boundaries-are-externallyepigastric-artery-internallyouter-margin-of-rectus-belowpouparts-ligament-the-following-are-the-coverings-of-the-two-varieties-ofinguinal-hernia-commencing-at-the-surface-o-oblique-direct-1-skin-1-skin-2CEDBW5.jpg ". Hernia, strangulated and reducible. With cure by subcutaneous injections, together with sugcested [!] and improved methods for kelotomy. Also an appendix giving a short account of various new surgical instruments. striangle and passes through the external ring. Hesselbachs triangle is situated at the lower part of theabdominal wall on either side. Its boundaries are: Externally.—Epigastric artery. Internally.—Outer margin of rectus. Below.—Pouparts ligament. The following are the coverings of the two varieties ofinguinal Hernia, commencing at the surface: o Oblique. Direct. 1- Skin. 1. Skin. Stock Photo")
RM2CEDBW5–. Hernia, strangulated and reducible. With cure by subcutaneous injections, together with sugcested [!] and improved methods for kelotomy. Also an appendix giving a short account of various new surgical instruments. striangle and passes through the external ring. Hesselbachs triangle is situated at the lower part of theabdominal wall on either side. Its boundaries are: Externally.—Epigastric artery. Internally.—Outer margin of rectus. Below.—Pouparts ligament. The following are the coverings of the two varieties ofinguinal Hernia, commencing at the surface: o Oblique. Direct. 1- Skin. 1. Skin.
RM2CEEBTB–. The anatomy and surgical treatment of hernia. a quantity of arterial blood was seen flowing downover the intestine within the sac, and the bowel being immediately returned, a consid-erable stream of arterial blood flowed into the sac. Pressure was made upon the groinin the situation of the epigastric artery, in order to prevent the htemorrhage, and appar-ently with success; but, four hours afterward, Mr. Steny was sent for on account of acopious discharge of blood from the wound. He made a further pressure, but withoutsuccess, and the man died in ten hours after the operation, becoming gradu
![. Hernia, strangulated and reducible. With cure by subcutaneous injections, together with sugcested [!] and improved methods for kelotomy. Also an appendix giving a short account of various new surgical instruments. Fig. 7. Is a part of Inguinal and Crural Hernia, with internal surface of peritoneum andits fascia removed, b, epigastric artery passing across and behind Poupartsligament between internal abdominal and crural rings to sheath of rectus atthe fold of Dough; s. c ; Pouparts and Gimbernats ligament, Hcsselbachstriangle, d; cord cf hypogastric artery,/; vas deferens duct spermatic, g;s Stock Photo](https://c8.alamy.com/comp/2CEDE39/hernia-strangulated-and-reducible-with-cure-by-subcutaneous-injections-together-with-sugcested-!-and-improved-methods-for-kelotomy-also-an-appendix-giving-a-short-account-of-various-new-surgical-instruments-fig-7-is-a-part-of-inguinal-and-crural-hernia-with-internal-surface-of-peritoneum-andits-fascia-removed-b-epigastric-artery-passing-across-and-behind-poupartsligament-between-internal-abdominal-and-crural-rings-to-sheath-of-rectus-atthe-fold-of-dough-s-c-pouparts-and-gimbernats-ligament-hcsselbachstriangle-d-cord-cf-hypogastric-artery-vas-deferens-duct-spermatic-gs-2CEDE39.jpg ". Hernia, strangulated and reducible. With cure by subcutaneous injections, together with sugcested [!] and improved methods for kelotomy. Also an appendix giving a short account of various new surgical instruments. Fig. 7. Is a part of Inguinal and Crural Hernia, with internal surface of peritoneum andits fascia removed, b, epigastric artery passing across and behind Poupartsligament between internal abdominal and crural rings to sheath of rectus atthe fold of Dough; s. c ; Pouparts and Gimbernats ligament, Hcsselbachstriangle, d; cord cf hypogastric artery,/; vas deferens duct spermatic, g;s Stock Photo")
RM2CEDE39–. Hernia, strangulated and reducible. With cure by subcutaneous injections, together with sugcested [!] and improved methods for kelotomy. Also an appendix giving a short account of various new surgical instruments. Fig. 7. Is a part of Inguinal and Crural Hernia, with internal surface of peritoneum andits fascia removed, b, epigastric artery passing across and behind Poupartsligament between internal abdominal and crural rings to sheath of rectus atthe fold of Dough; s. c ; Pouparts and Gimbernats ligament, Hcsselbachstriangle, d; cord cf hypogastric artery,/; vas deferens duct spermatic, g;s
RM2CF5DHB–. Abdominal hernia : its diagnosis and treatment. ^. Right labial hernia (complete oblique inguinal), similar to scrotal hernia in the male. body without much tendency to follow the cord (figs. 21 and22). Coming out to the inner side of the deep epigastric artery,it protrudes directly through the external abdominal ring. Thecord is at its outer side from the median line, and its coveringof intercolumnar fascia prevents its descent into the scrotum.When small, it can usually be easily reduced by the pressure ofthe hand with the patient standing. Its diagnosis is attended7 98 ABDOMINAL HERNIA. b
RM2CEN13N–. On retro-peritoneal hernia : being the 'Arris and Gale' lectures on the 'The anatomy and surgery of the peritoneal fossae' : delivered at the Royal College of Surgeons of England in 1897. of a hepatic flexure. Therewas a considerable degree of peritonitis in the epigastric area,and a few fresh adhesions united the ascending colon to theliver. The liver showed no morbid change of any kind.The stomach was merely distended. All the other viscerawere perfectly normal. It was evident that the caecum was undescended, and had led the way through the foramen. HERNIA INTO THE FORAMEN OF WIN SLOW 155
RM2CEED62–. The anatomy and surgical treatment of hernia. f the epigastric vein ofboth sides. 11, II. Continuation and distribution of theright epigastric vein. 12, ij. The superior external pudendal arterywhich crosses over the hernia immediately under the skin. 14,14. The saphena vein. 75, 75. The anterior crural nerve. 16,16. Two dotted lines, showing the direc-tion which the viscera sometimes take in the for-mation of internal inguinal hernia, or on the inner^side of the epigastric, in which case this arteryretains its natural situation. A. The external oblique muscle of the abdo-men. B. B. The rect
![. A manual of operative surgery . it is to be brought through the small openingmuscles. E.O., External oblique; Ep. v., Deep epigastric vessels; CM.The spermatic cord is not shown for the sake of clearness. Conjoined neck and tied with the Staffordshire knot. The ends are cutshort, and the stump left to itself. 2. The sac being ligatured in the manner described, each endof the ligature is successively threaded on a mounted needlewith its eye close to the point. Guided by the left index finger chap, xii] RADICAL CURE OF INGUINAL HERNIA 343 the needle is made to transfix the transversalis and ob Stock Photo](https://c8.alamy.com/comp/2CJ38RB/a-manual-of-operative-surgery-it-is-to-be-brought-through-the-small-openingmuscles-eo-external-oblique-ep-v-deep-epigastric-vessels-cmthe-spermatic-cord-is-not-shown-for-the-sake-of-clearness-conjoined-neck-and-tied-with-the-staffordshire-knot-the-ends-are-cutshort-and-the-stump-left-to-itself-2-the-sac-being-ligatured-in-the-manner-described-each-endof-the-ligature-is-successively-threaded-on-a-mounted-needlewith-its-eye-close-to-the-point-guided-by-the-left-index-finger-chap-xii-radical-cure-of-inguinal-hernia-343-the-needle-is-made-to-transfix-the-transversalis-and-ob-2CJ38RB.jpg ". A manual of operative surgery . it is to be brought through the small openingmuscles. E.O., External oblique; Ep. v., Deep epigastric vessels; CM.The spermatic cord is not shown for the sake of clearness. Conjoined neck and tied with the Staffordshire knot. The ends are cutshort, and the stump left to itself. 2. The sac being ligatured in the manner described, each endof the ligature is successively threaded on a mounted needlewith its eye close to the point. Guided by the left index finger chap, xii] RADICAL CURE OF INGUINAL HERNIA 343 the needle is made to transfix the transversalis and ob Stock Photo")
RM2CJ38RB–. A manual of operative surgery . it is to be brought through the small openingmuscles. E.O., External oblique; Ep. v., Deep epigastric vessels; CM.The spermatic cord is not shown for the sake of clearness. Conjoined neck and tied with the Staffordshire knot. The ends are cutshort, and the stump left to itself. 2. The sac being ligatured in the manner described, each endof the ligature is successively threaded on a mounted needlewith its eye close to the point. Guided by the left index finger chap, xii] RADICAL CURE OF INGUINAL HERNIA 343 the needle is made to transfix the transversalis and ob
RM2CEEB7H–. The anatomy and surgical treatment of hernia. IRREDUCIBLE INGUINAL HERNIA.—SYMPTOMS AND COMPLICATIONS. 79 PLATE XIX* Figure l. Figure 4. Two external inguinal hernia; (enteroceles). Double external inguinal hernice. That of the Male, aged forty-six. left side of enormous size. (Copied from a design a. Tumor in the inguinal canal. of Dupuytren.) The right hernia is yet reducible. /;. Contraction or obstruction of the internal The left hernia, irreducible, contains the greater inguinal ring. part of the intestinal mass. The abdomen, almost c. Passage of the epigastric vessels under the empty,
RM2CHR5HD–. American practice of surgery ; a complete system of the science and art of surgery . of laparotomy wounds at the middle line, in the region of theappendix, in the epigastric and gall-tract regions, and in the lumbar region, atthe site of the incision made for a kidney operation. They also may appear atthe site of any wound or laceration due to an injury (jr a stab or bullet wound. In the Mercy Hospital Clinic I recently had under my care a patient who, inconsequence of a crushing injury of the chest and abdomen, had experienced afalse hernia of the colon and part of the liver, complicating a
RM2CDA98M–. Surgery, its principles and practice . ion be-tween congenital and ac-quired hernia has already^^ been sufficiently dealt ^» with under General Re- marks (p. 18). Oblique Inguinalj;: Hernia. — This is the most common of all var-ieties of hernia, 93 percent, of all ingumal her-nias being oblique. Anatomic Rela-tions.—In oblique in-guinal hernia the sacemerges from the abdo-men through the internalring above and a littleoutside of the deep epi-gastric artery; it thenpasses downward in anoblique direction, par-allel with Pouparts liga-ment, crossing almost at right angles the deep epigastric ve
RM2CEE50B–. The anatomy and surgical treatment of hernia. e turneddown. f, e. Fascia transversalis at its inner part; theepigastric artery and vein are seen. /,/. Sheath cut open. g. Femoral artery.h. Femoral vein. /. Saphena major. k. Epigastric artery and vein. /. Circumflexa ilii. m. Internal abdominal opening for the sper-matic cord. n. Space between the crural sheath and fem-oral vein, showing the part at which the cruralhernia descends. Figure 7. Artery and vein removed from the sheath. a. Pubes. b. Ilium. c. Fascia transversalis. d. Aperture in it. e. Fascia transversalis. /. Anterior part of the
RM2CEED8F–. The anatomy and surgical treatment of hernia. abdominal ring. , -„ i- r „ *- * b. Poupart s ligament. /, /. Intestine. t . 1 ur i a .- ^ a --^ c,c. Internal oblique muscle and its tendon. Figure 2, d. Transversalis passing over the hernial sac. a. Strangulated intestine, the sac cut open. ? fascia passing up to the transversalis. b. The adhesions of the tunica vaginalis to the f- Hernial sac below the abdominal ring,mouth of the sac S- The sac passing under the transversalis into the abdomen.?Tigute J. j^ Dotted lines marking the direction of the Hernia congenita. epigastric artery as it run
RM2CEE1BC–. The anatomy and surgical treatment of hernia. Guys Hospital. Fig. 2 is in my own possession. Figure I. a. Symphysis pubis. b. Spinous process of the ilium.<r, c. Abdominal muscles. d. The crural arch, or Pouparts ligament. e. Semilunar edge of the fascia lata. /. Tendon of the external oblique cut open.g. Internal oblique and transversalis.//. External portion of the fascia transversalis./. Internal portion of the same fascia.k. Internal abdominal ring./. External abdominal ring./;/, m, III. Spermatic cord passing through bothapertures to the testis.11. Testis.o. Epigastric artery. p. Cre
RM2CEE5BJ–. The anatomy and surgical treatment of hernia. Fia € / S FEMORAL HERNIA.—SPECIAL ANATOMY OF THE PARTS. 125 k. Femoral sheath./. Femoral artery.m. Femoral vein.n. Saphena major vein.o. Anterior crural nerve.p. Fascia lata turned back.q. Tendon of the external oblique muscle,drawn down. Figure 4. Posterior view of the place at which the cruralhernia descends, as it appears when the peritonseumis first stripped off. a. Pubes. b. Abdominal muscles. c. Round ligament passing into the inner ab-dominal ring. d. Femoral artery. e. Femoral vein. /. Epigastric artery.g. Epigastric vein. h. Depression
RM2CEE1CF–. The anatomy and surgical treatment of hernia. / .4% , -V^ 7 5M»1. OPERATIVE MEASURES FOR STRANGULATED FEMORAL HERNLA. 141 /, k. Fascia propria of the sac laid open. h. The iliacus internus muscle. /, /. Hernial sac opened. /, /. Fascia transversalis. in. Omentum seen within the sac. k. Internal abdominal ring. /. Spermatic cord passing through the inter-nal rina;. Figure Posterior view of Fig. i. m. External iliac artery. a. Symphysis pubis. «. External iliac vein. b. Spinous process of the ilium. o. Epigastric artery and vein. c. Ilium cut through. /. Sac of the crural hernia.(/, d, d. Re
![. Text-book of operative surgery . -. ^ Circumflex iliac a. , and ijsoas abscess. j Ext. cutaneous n. / Common |fenioral a. / Subhyoid pharyngotomy.Carotid a.Thyroidectomy.Subclavian a. Bxposure of the heart.. Int. saphenous v. Brachial a. Ueep epigastric a. nf- Ext. iliac a. /Inguinal incision/ii,;i| *- (castratiuu, hernia). iledian n. Suprapubic cystotomy. Arthrotomy) /;;:#}^^of knee, inter- ]—J-rT^iy 1nal incision. j | - , fjl I fPost.Iß l { tibial; Fig. 15. Fig. 15«. .FiGS. 15 aud 15«.—A few normal incisious illustrateJ ou Langera figures. OPERA Tl VE S URGER Y Great occipital n. Grea Stock Photo](https://c8.alamy.com/comp/2CHP1WT/text-book-of-operative-surgery-circumflex-iliac-a-and-ijsoas-abscess-j-ext-cutaneous-n-common-fenioral-a-subhyoid-pharyngotomycarotid-athyroidectomysubclavian-a-bxposure-of-the-heart-int-saphenous-v-brachial-a-ueep-epigastric-a-nf-ext-iliac-a-inguinal-incisioniii-castratiuu-hernia-iledian-n-suprapubic-cystotomy-arthrotomy-of-knee-inter-j-rtiy-1nal-incision-j-fjl-i-fposti-l-tibial-fig-15-fig-15-figs-15-aud-15a-few-normal-incisious-illustratej-ou-langera-figures-opera-tl-ve-s-urger-y-great-occipital-n-grea-2CHP1WT.jpg ". Text-book of operative surgery . -. ^ Circumflex iliac a. , and ijsoas abscess. j Ext. cutaneous n. / Common |fenioral a. / Subhyoid pharyngotomy.Carotid a.Thyroidectomy.Subclavian a. Bxposure of the heart.. Int. saphenous v. Brachial a. Ueep epigastric a. nf- Ext. iliac a. /Inguinal incision/ii,;i| *- (castratiuu, hernia). iledian n. Suprapubic cystotomy. Arthrotomy) /;;:#}^^of knee, inter- ]—J-rT^iy 1nal incision. j | - , fjl I fPost.Iß l { tibial; Fig. 15. Fig. 15«. .FiGS. 15 aud 15«.—A few normal incisious illustrateJ ou Langera figures. OPERA Tl VE S URGER Y Great occipital n. Grea Stock Photo")
RM2CHP1WT–. Text-book of operative surgery . -. ^ Circumflex iliac a. , and ijsoas abscess. j Ext. cutaneous n. / Common |fenioral a. / Subhyoid pharyngotomy.Carotid a.Thyroidectomy.Subclavian a. Bxposure of the heart.. Int. saphenous v. Brachial a. Ueep epigastric a. nf- Ext. iliac a. /Inguinal incision/ii,;i| *- (castratiuu, hernia). iledian n. Suprapubic cystotomy. Arthrotomy) /;;:#}^^of knee, inter- ]—J-rT^iy 1nal incision. j | - , fjl I fPost.Iß l { tibial; Fig. 15. Fig. 15«. .FiGS. 15 aud 15«.—A few normal incisious illustrateJ ou Langera figures. OPERA Tl VE S URGER Y Great occipital n. Grea
RMRN6TTA–. Anatomy, descriptive and applied. Anatomy. Figs. 474 and 475.—Variations in origin and course of the obturator artery. When the obturator artery arises at the front of the pelvis from the deep epigastric, it descends almost vertically to the upper part of the obturator foramen. The artery in this course usually lies in contact with the external iliac vein and on the outer side of the femoral ring (Fig. 474); in such cases it would not be endangered in the operation for femoral hernia. Occasionally, however, it curves inward along the free margin of Gimbernat's ligament (Fig. 475), and under
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