SURGICAL ANATOMY OF THE ABDOMEN 13 



by means of the mesentery from the underneath portion 

 of the spine in a spiral form ; owing to the length of the 

 mesentery and this mode of attachment, volvulus of the 

 bowels is, unfortunately, only too common. The small 

 intestines hang well in the centre of the body, and lie in 

 the curve formed by the double colon ; they terminate at 

 the caecum, crossing to the right side for this purpose, 

 and opening into the gut close to the colon, but below it. 

 This part is situated beneath the third lumbar vertebra, 

 about 6 inches from its under surface. 



The Large Intestines are represented by the caecum, 

 colon, and rectum ; they occupy a fairly regular position, 

 and a knowledge of their disposition and course is im- 

 perative. The ccBCum, or ' blind gut,' contains, on an 

 average, about 8 gallons of fluid, and is over 3 feet 

 in length. It usually occupies a position obliquely from 

 above downwards and forwards, and presents superiorly 

 a base, and inferiorly an apex. The superior extremity, 

 base, or arch, or, as well designated by Chauveau, 

 'crook,' is situated in the right lumbar region close 

 under the spine ; it is in relation with the right kidney, 

 duodenum, psoas muscles, colon, small intestines, and 

 pancreas. The crook or arch looks forwards, and in 

 the concavity of the curve on its inside the small in- 

 testine opens and the colon begins. The inferior ex- 

 tremity is placed within the double colon at its sternal 

 curve, the apex resting on the ensiform cartilage of the 

 sternum ; at least, this is its usual position. The colon is 

 divided into two portions, the single and double ; it is 

 about 12 feet in length. For convenience of description 

 the donhle colon is divided into four parts ; commencing 

 from the crook of the caecum, it proceeds forwards and 

 downwards, passing beneath the right kidney (having the 

 pancreas between it and that organ) to the diaphragm, 



