It was
covered with fat and occupied the whole left half of the thoracic
cavity. The spleen, pancreas, and transverse colon were also
superior to the diaphragm. Death was caused by a well-defined
round perforation at the cardiac curvature the size of a
sixpence.
Anomalies of the Intestines.--The Ephemerides contains the
account of an example of double cecum, and Alexander speaks of a
double colon, and there are other cases of duplication of the
bowel recorded. There is an instance of coalition of the jejunum
with the liver, and Treuner parallels this case. Aubery, Charrier
Poelman, and others speak of congenital division of the
intestinal canal. Congenital occlusion is quite frequently
reported.
Dilatation of the colon frequently occurs as a transient
affection, and by its action in pushing up the diaphragm may so
seriously interfere with the action of the heart and lungs as to
occasionally cause heart-failure. Fenwick has mentioned an
instance of this nature. According to Osler there is a chronic
form of dilatation of the colon in which the gut may reach an
enormous size. The coats may be hypertrophied without evidence of
any special organic change in the mucosa. The most remarkable
instance has been reported by Formad.
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