CHAPTER XXI 



DISPLACEMENTS OF THE DOUBLE 

 COLON — Concluded 



C. Torsion of the Pelvic Flexure : Its Diagnosis, 

 and Differential Diagnosis between that Con- 

 dition and Simple or Subacute Impaction of 

 the Same Portion of the Bowel 



Definition. — Torsion affecting the extreme end of the 

 colic loop, thus involving the last third of the second 

 division, and the first third of the third division of the 

 bowel. 



So far as my experience goes, I have found torsion 

 of this portion of the bowel always of the incomplete 

 variety — just a mere doubling or bending over of the 

 iiexure. 



Causes, Symptoms, and Diagnosis. — These, as 

 relating to incomplete twist of the colon in general, have 

 been fully described in Chapter XIX. It often happens, 

 however, that torsion or displacement as affecting the 

 pelvic flexure alone may be diagnosed. In order to 

 draw attention to this I recapitulate here something of 

 what has been said in Chapter XIX., concluding with 

 what I believe to be a further important matter — namely, 

 the means we now possess of differentiating between 

 torsion of the pelvic flexure and its mere impaction. 



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