548 THE DIGESTIVE SYSTEM. 



turned inside out, its mucous membrane is in contact with the mucous membrane of 

 the outer portion. In rare cases the intussusception is complicated by the invagination 

 of a second portion of intestine in the inner tube, and even by a third intussusception 

 into the second one. These changes occur both in the large and small intestine; most 



FIG. 321. -INTUSSUSCEPTION. 



A portion of the gut Is completely invaginated in the segment below and strangulated. 



frequently the lower part of the ileum is invaginated in the colon. The invagiuated 

 portion may be from a few inches to several feet in length. The lesion is most fre- 

 quently found in early childhood. 



The intussusception, by the dragging and folding of the mesentery which it in- 

 volves, may lead to intense congestion of the parts, and even to large haemorrhages be- 

 tween the coats of the intestine. The congestion may induce fatal peritonitis, or gan- 

 grene of the intestine, or chronic inflammation and adhesions, and the patient may live 



FIG. 322.- INTUSSUSCEPTION AGONAL OR POST-MOKTEM IN INTESTINE OF INFANT. 



for a considerable time with symptoms of stricture. In other cases the invaginated 

 portion of intestine sloughs, the outer and inner portions become adherent, and the 

 patient recovers, with or without stricture. 



Besides this grave form of intussusception we often find, especially in children, one 

 or more small invaginations not attended with congestion or inflammation. These are 

 agonal or are formed immediately after death (Fig. 322). 



