Report of an autopsy on the bodies of Chang and Eng Bunker, commonly known as the Siamese twinsAllen, Harrison
History
Report of an autopsy on the bodies of Chang and Eng Bunker, commonly known as the Siamese twins
Allen, Harrison
Conjoined twins
In the subject, as it lay on the table with the flap _a, b_ (Fig. 2),
turned to the left, the suspensory ligament had the appearance of being
much more obliquely inclined to the left, and could be made nearly
horizontal by a little traction. Lying beneath this ligament, but
belonging to the anterior abdominal wall, was a large mass of
subperitoneal fat about the size of a pigeon’s egg. Extending to the
extreme left, and continuous with the anterior border of the left lobe
of the liver, was a delicate prolongation of liver substance which was
lost within the connecting band.
[Illustration Figure 7:
Fig. 7. The abdominal organs of Chang in position—the small
intestines removed.
A. Left lobe of liver.
B. Right lobe of liver.
C. Gall-bladder.
D. Suspensory ligament.
E. Lobules of fat in the position of the termination of the
umbilical ligament. ]
The upper surface of this prolongation was supported by a fold of
peritoneum, extending directly upward, apparently attached to the base
of the ensiform cartilage. Visible upon the anterior aspect of this fold
was a tortuous artery, afterwards found to be the left internal mammary.
This fold may be called _the accessory suspensory ligament_; nothing
similar to it was seen in Chang. The left lobe of the liver, save a
portion of its anterior edge, was not visible.
In Chang (Fig. 7), by exposing the parts as in Eng, throwing the
abdominal flap, _c, d_ (Fig. 2), to the right, there was at once brought
into view the transverse colon, the greater omentum, and greater
curvature of the stomach. The latter organ was large, empty, and without
any undue traction could be so displayed as to yield its fundus and
greater curvature in position. The fundus was not visible. Lying
conspicuously within the left hypochondriac region was the spleen. Its
inferior free border, with its peritoneal attachment, was distinctly
seen; its upper portions, however, were invisible. The left lobe of the
liver held a position answering to that of the right lobe in Eng—the
external lateral ligament being stretched across the left hypochondriac
region, pursuing a similar course to the external lateral ligament of
Eng (_q. v._). The left lobe at its outer portion rested upon the
spleen, its inner portion upon the stomach. The outer portion of the
left lobe presented a thin compressed border, the inner portion was
divided by a deep sulcus into two lobes.
The right lobe lay deep within the right hypochondriac region, the
portion about the longitudinal fissure anteriorly, alone appearing in
the dissection. The suspensory ligament held a position similar to that
in Eng. The gall-bladder held its normal position to the right lobe, and
was moderately distended with bile.
Both Chang and Eng had the organs occupying the hypochondriac and
epigastric regions retaining, on the whole, such relations as are
usually observed.
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