Annals of Surgery Volume 32

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated.1900 Excerpt: ... tion nor disease. Nothing further was done at this time. Following the operation no improvement in the constipation took place, nor was there any marked relief to the symptoms. December 29, 1899, tne patient was readmitted to St. Mary's Hospital, and the ileocaecal coil exposed. An incision was made two and one-half inches in length at right angles to the ileocaecal juncture, having its centre at that point. The wound was sutured transversely, after the manner of the Heineke-Mikulicz pyloroplasty, making a very considerable increase in the size of the aperture between the ileum and caecum. The bowels now act regularly or with slight aid and in marked contrast to the previous condition. The pain and tenderness have disappeared and the general condition has vastly improved. The time which has elapsed is too short to give this case much value, and my purpose in reporting it is to call attention to some facts which a superficial investigation of the subject has brought forth, and to some deductions from the facts which may be and probably are true. The literature bearing on the subject as to the function of the ileocecal valve is meagre. It seems to be taken for granted that its main purpose is to prevent the return of material of any kind from the large into the small bowel, and there is no doubt that this is one of its functions. The ileocaecal valves consist of two semilunar folds of mucous membrane situated one superiorly and the other inferiorly, leaving a transverse slit between at the point of junction of the ileum and caecum. On one side of the valve is the mucous membrane of the small bowel, on the other that of the large intestine. Immediately at the base of the valves is a circular fold of muscle fibres forming a constrictor muscle having much the ap...