The opening was in the
abdominal walls outside of the internal inguinal ring. The
writhings of the intestines were very conspicuous through the
walls of the pouch.
Dade reports a case of prodigious umbilical hernia. The patient
was a widow of fifty-eight, a native of Ireland. Her family
history was good, and she had never borne any children. The
present dimensions of the tumor, which for fifteen years had been
accompanied with pain, and had progressively increased in size,
are as follows: Circumference at the base, 19 1/2 inches;
circumference at the extremity, 11 1/4 inches; distance of
extremity from abdominal wall, 12 3/4 inches. Inspection showed a
large lobulated tumor protruding from the abdominal wall at the
umbilicus. The veins covering it were prominent and distended.
The circulation of the skin was defective, giving it a blue
appearance. Vermicular contractions of the small intestines could
be seen at the distance of ten feet. The tumor was soft and
velvety to the touch, and could only partially be reduced.
Borborygmus could be easily heard. On percussion the note over
the bulk was tympanitic, and dull at the base. The distal
extremity contained a portion of the small intestine instead of
the colon, which Wood considered the most frequent occupant.
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