SUBACUTE OBSTRUCTION OF THE PELVIC FLEXURE 127 



twist itself was accountable for the engorgement of the 

 distended second portion of the bowel. Of that I may 

 have more to say at some future date. It is sufficient 

 now if it serves to point out the difference in size of 

 these two sections of the colon, and the special liability 

 of this portion of the intestinal tract to trouble accruing 

 from obstruction. 



In order to make this point quite clear, I insert here a 

 further photograph of the same case of twist (see Fig. 10). 



Fig. 10.— VoLVULns of the Pelvic Flexure of the Colon— 

 THE Colon pulled out from the Abdomen and extended. 



I, The pelvic flexure of the bowel ; 2, the second portion ; 

 and 3, the third portion of the bowel. 



Here we have the suprasternal and diaphragmatic 

 flexures obliterated by removing the colon from the body 

 and drawing it out to its full length. The marked 

 difference in size of the two portions of the bowel we are 

 considering is then made quite apparent. Portion 

 number three, nearly empty, lying beneath the over- 



