:}<> l'K(M'KKI)]N(iS OK THK ANATOMICAL AND ANTHROPOLOGICAL 



Discussion followed the various papers. 



The meeting closed with votes of thanks to Mr. Andrew and 

 Mr. Smith. 



; i 



A CASE OF HERNIA INTO THE FOSSA DUOPENO-JE.TUNALIS. 



By CHARLES T. ANDREW, B.Sc., M.B., Ch.B., Aberd., Junior Assistant to the 

 Professor of Anatomy, Aberdeen University. 



This rare form of hernia was found in an old male subject in 

 the dissecting room. When the abdominal wall was opened by a 

 crucial incision in the course of dissection it was noticed that no 

 small intestine was visible when the great omentum was thrown 

 upwards ; also that there was a large empty cavity in the pelvis 

 between the sacrum and the bladder. As the parietal peritoneum 

 was reflected on to the fundus of the bladder 1| inches above the 

 symphysis pubis I thought at first that the space was due to the 

 fact that the bladder, prior to hardening in formalin, had been 

 greatly dilated and so pushed the small intestine out of the pelvic 

 cavity. There appeared also to be a large empty space under the 

 left dome of the diaphragm of such dimensions that the closed fist 

 could with ease be slipped under the costal margin, a thing which 

 cannot be done when the subject has been hardened by formalin. 

 In this space the whole of the gastric surface and anterior border 

 of the spleen could be seen from the outside without first drawing 

 the stomach to the left. The whole of the small intestine, with 

 the exception of the lower 6 inches of ileum, lay in a large sac 

 of peritoneum, which ran across the abdomen, lying in the epigastric, 

 umbilical, left hypochondriac, and left lumbar regions. To the left 

 the sac extended to the extreme left of the abdomen ; to the right 

 as far as the margin of the right rectus muscle. Situated 1 inch 

 above the bifurcation of the abdominal aorta, and slightly to the left 

 of the mid-line, there was found a distinct semilunar-shaped opening 



1 Upon further examination the hernia was found to lie in the para-duodenal 

 fossa. (B. W. REID). 



