FLEXION OF THE DOUBLE COLON 297 



' traction.' Probably the best example of this is to be 

 found in those cases where an impacted pelvic flexure is 

 found forced right into the pelvic cavity, taking up the 

 position normally occupied by the bladder. In such an 

 instance we then have not only the condition of impaction 

 to deal with (see Chapter X.), but again a condition of 

 abnormal flexion in an anterior portion of the bowel. 

 This is the way in which it occurs : 



We know that normally the pelvic flexure lies close 

 within our reach near to the pelvic brim. When impacted, 

 there is always a tendency for this weighted end of the 

 colic loop to be forced backwards by the paining attempts 

 of the animal at defaecation. Ordinarily, the paining of 

 the animal (the pains in this condition not being exces- 

 sive or violent) serves only to impinge the impacted 

 flexure on the pelvic brim. On occasions, however, it is 

 thrust further back still, until, as we have just now said, 

 it comes to occupy the pelvic cavity. 



This thrusting back of the weighted end of the loop 

 means a pulling on and an obliterating of the supra- 

 sternal and diaphragmatic flexures.^ And in such in- 

 stances, unless this is recognized, and the impacted 

 flexure is repelled and made to take up its normal position 

 in the abdomen, then it means that so long as this ab- 

 normal position of the impacted pelvic flexure is allowed 

 to continue, so long is dangerous flexion in existence 

 at points just anterior to the suprasternal flexure and 

 posterior to the diaphragmatic flex ure. 



Symptoms and Diagnosis — These may conveniently 

 be discussed together, for there is really but little to add 

 to what has already been said in other portions of the 

 book. It is evident, for instance, that the symptoms will 

 be those of ordinary subacute impaction of the bowel, as 

 1 Cadeac, ' Pathologie Interne,' vol. ii., p. 307. 



Digitized by Microsoft® 



