TORSION OF THE PELVIC FLEXURE 305 



Impaction. Twist. 



See Chapter X. See Chapter XIX. 



2. Pulse full, and normal in 2. Pulse constantly quick, and 

 number of beats, except during slowly progressing to a running- 

 the paroxysms of pain. down character. 



3. Respirations deep and reg- 3. Respirations short, catchy, 

 ular, only becoming quickened and laboured ; may be termed 

 and catchy during pain. ' sobbing.' 



4. Temperature normal. 4. Temperature raised to 



103° F. 



5. No straining on rectal ex- 5. Marked straining on rectal 

 amination. Rectum 'ballooned.' examination, with spasmodic 

 No marked spasmodic contrac- clasping of the bowel on the 

 tion of its walls. inserted arm. 



6. Rectal examination reveals 6. The pelvic flexure is alto- 

 the presence in the pelvis of the gether missing from its position 

 ingesta-packed pelvic flexure. near the pelvic brim. 



In conclusion, but without belittling any other of the 

 evidence, each portion of which forms a link in our chain 

 of reasoning, I would remark on the importance of the 

 information gained by rectal examination. When we 

 find per rectum the knee-shaped, ingesta-packed portion 

 of bowel as described in Chapter X., it is conclusive 

 evidence of impaction of the pelvic flexure. Similarly, 

 when careful exploration fails to reveal the pelvic flexure 

 in its normal position near the pelvic brim, the evidence 

 is just as conclusive that we are dealing with a case of 

 pelvic displacement. 



Two Recorded Cases of Torsion of the Pelvic 

 Flexure. — As the report of an actual case is always 

 interesting, I give below two cases of torsion of the 

 flexure which occurred in my own practice. They are 

 interesting not only as concerning torsion of the flexure 

 alone, but may be read in connection with the description 

 pf incomplete twist as given in Chapter XIX. 



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