SURGICAL ANATOMY OF THE ABDOMEN ii 



pyloric is below the cardiac. A very singular and 

 important arrangement of the pylorus and duodenum 

 exists ; dissection reveals that the duodenum, where it 

 commences at the pylorus, is S-shaped and much dilated, 

 forming an arrangement not at all unlike an S-trap used 

 in drain-pipes (see Figs. 2 and 3). This direction of the 

 duodenum appears to regulate the pace at which the 

 ingesta should pass through ; as soon as the trap is 

 formed, the duodenum ascends towards the spine lying 

 all the while on the colon. It is easy to see how simple 



Fig. 2. — Longitudinal Section of Stomach and Pylorus. 



a, Opening of cardia ; h, pylorus; c, commencement of 



duodenum ; d, pyloric or duodenal ' trap.' 



it is for a distended stomach and intestines to press upon 

 the pyloric trap, and practically occlude it ; this is the 

 second factor in producing ruptured stomach. 



The Small Intestines are divided by the anatomists 

 of the present day into two portions, the Jixed or duodenal 

 and free or floating ; they are about 70 feet in length. 

 The duodenal portion commences from the pylorus, 

 passes under the concave surface of the liver in a direc- 

 tion upwards and outwards, lying on the double colon 

 and passing in apposition with the last rib, where it may 

 readily be found at the lower part of its upper third, just 



