Jo

.·~;;D~I

··~n tom.,

9 ' s,',:· ' .. , "0

~.' ';

.. .,' - ... "

no,.,~

'" .1-

, ,I m~ 'I'~'I'" terms,

7'

I

b,

'~lIlh'~:~.

~ii3~ ~illlI!'!I ~.~Ii!i"~IIit!lIi.~ •• lliit&.llitl3li.~ ~illlli~ IIIJ.i1'l!iill~1 1111 •• ~ill~l!13 liili~l~ill~11Ii !!II iii iI i!i.I~IIIIi~lil.IIIi~.I~I~~ilJ.~ •• l. ill~~!i.~ ~.I~I~ Ii.

I

~!II.IIii.foIi. i!1~.;8ili.l~

'··P·,p····

, ,

T

!'I!!I!~'!I!!I!L~ !lW!I!!I! I! !I! !I'!I!"I[!Ii!lI!!I!~[!ti!lI[!I!!I! 'JI!. !Ii"~JI! II". lil!~l'" 1Ii!ll ~!I!~llllilll"~IIi"~JI.III". 1i":lll .. iil ... ~.illli[jJ lili~ .1111 ril!llli~ i;.iI [J']~llli~ i;lil

~'" 'XI.I

I!

'.

[

-7

~ 1_,

'2.-1

( .

up

.

IS

C 'Of' pili m'sd'is

Basal la e' -~~:=

I!!

clni _n cor -.u,sdl· :

I !!'

,~

~. "

II,

rs

J"'IU"'-.'"

, . .:: ii!:',1 "

:,>tll

' ..

III

1_'1 ,_',' I

:1 S In

C, COin '.err _III ICII~OIII IS U bell ]Ijnla~

IL L!DOIJ connICf"" 'live l~hJSU111

0111 g;1 'aus~la ..

, la~_l inll.r[~c:II~ --;:-_ ~I

_~

fl:-IU m

_:__ml

i

,"" ....... ,._,.r _

I',: ill. p,Il,~ IU, ~., ~ I ~ _

Iii

i!! " I"' "iii

, III

'0 or

th II "

IdL", ....

d

" ,

I 0 ,

..

. j I ~

th,

I

I osdolrfgr : lUll: af_"o""""

Ii __ '.-

I

---,_~ __ .. I_ .. _' P

. ~'r'o,u. I _'~

-I!!;

'"-', -.

~,'- __ ' .r,:

the lesion '< ---hit ma

r

E·' -a:l!'!ilrli

.:.' .. i.u!II~~i

-,lissrCI:,

-!'!!IiilJl'A "ii!iiI]

~[~ .... _Ui

iCrs -

I ' , '

," "

i I I ~ '. 'iI!

~g,- ra 1 .. 9

~ 'J

,'.'U,

I!'

r

t o tn ..

;0;

rml ...

I."c. te ..

~

J., "-1' ~ r

F'

,

Iii

EllUptieal

........ 5 em

flrlD Ifel!i,on

, the

• • f •

"

'0 0

r !iii'_'

,"·e· e', "~ ",':, 'a]::,lnant'

I 1

Ths r: :n·t'o .. :~' 'Sll'

I . V' .. , ... - .~- .. ,

_]

~

ve m

...

sion,

._.·~elml: __ "_ '_

d

.... , Rf1:Q~DnaILy~I'.-, .. !liP'li_ h

I .1-i_.-;tH_

, I ... ~

····u·

.. '. ".:' . . .

. ·Ii'· '[h-'

up to [_I,~ 7~'· :m

(.

skin ". lir

h- ~I ~

i' .... ~ •. ~t

.. ,,:" dias nosis of m elan 'm:~<, \~l~~t" thi ~'-·n.1 ess

I.'

palp ab I,' ~'"," !l'h no",' ~ ~~~. " , 'n m · ," les ~ I' ~ . i "-~;

J: co

,-" /Ii'

i!!' h

. ..,. .

." .. '" t f_ i.' ,'-,:

,,!j!i

'a···· _. I , ..." ,,' if,"'h-" "'~ id -j, ';"i'~ ~!,-- ",'11 - r', Ii'h-' ,. -'r-'

Ii! , L, ., , , ' ,,,", , • . , " ' ~ Ill. , I WI! " ~'"

..

,Spili';.., ".,-';cknes,s rGraift t, _p1idlJrmis I"-~:US Pa;:" ',;-' Dennis}

.' -, j'- ~ in '"' n:i0~ Ilu -,~ -', . ~')-,:. '1=. '.. "i,,·;

." L,' . I IL~ ~ I -._ -. 1I .. . II '" ,.'. . I ' "

··N"" .. ,C""I ~I~I

·O"OR

arm

: ' [In. ' '~I , . ti ;: " . 'f~ ,; ')'. - Ii!"::. 'I'" "., , ", it'.;i] :;,'1",.

iiI "i~~ , 'Ii ,,6111 .. III'LIl.~

, .. '"

. I

F-ron iaJIll, _ .Ie _

. 1--:'~ .-.~J ._:__IFlII' .. ,~JI' ... _.

\

2' em segment rem ~~.liVld

,'n;, ,;I

I ,.:'

, g

. i 'I I --.,

, '

I~ "otal e

, i .~

: "~

To ,I Excision (Avu/S'ion J 0,' Naill

: ,Ill

,

" I ", It'

U~"_I

'0

:_ '." / " '_:

"a~[~ ~p~ ,',"'" ,'oaer n8·~ 'foJd "'"

neisJon I il189 '~ct_ '~ ~ ",','~: '-, '

~.

1-,,'

,._ " £J;

', .. Ui

"'I"""'p'

:.~ .i, . '-: !. . ~_I 'f"

!,6',' ,;:-'

, , I ~ • ,

t. 17)

R~ '-~J.

", -. . tl I - ~

emove 3.,

~ ,. 0 ~ ,'"UU"L"""",,

ii

i' ./

11

1 ;~, Silli n,

", _ f' - N'" ~ ,il-'

I -,:'.' ,'" ~ ',I .

.. . . ' ..

__

,.~ ,r

'!e

. I ' ~

~

I·! '

" n" I 'I'iIi . "~'lll J" '''~.

- .. \.~"

. ,

1n _ ,_ ,

,

." . - ..

, i

';-; ;'t" =

__ "" ,111.,_ II

.: . ith""

. ,"~, II). I~ • • "

n-

, ~.d

I'

'f.: ]:1

..

rrnnt

" '5"-1

. ': I, .'

" ,- -t i -, "

- ! _'.' I .' J

"'O'~" ',- I

'- ", .

'. " I

I, ' __ ' __ :

,. ',~gure 2I04i ',-hie Clant,:" ts ,0. Ih.e : ,,[Ubi, iane ibl ,~a,r :.,ria,nQl1IIs "J1e second surgi~' c~-~Jl- ,.e' .' ~ . --~~ ,D(su_,-e o'l'hei I-,-pel-t~ ~a" '-,,' -' .. i[on 0'_ the i,;, ,~-_m __ -J:-'l",ula[r g~:-_n;-'., (,:y PSII1"iSI,iolil [a' JE S-:a,rn:~-I~--I,akil ,SW iG[ra.Y, and JR: [Rowis Am ~':rg'-5(91:',: 519~59-61 19,'''~,,)

T'~re

2-'3'-

.

I i.' "

-Ii

,~ . -,

Ii ..,;

:8

Dr'illiil'iiI'J""'"I' . JIUWlt .,,~ .

-,-,., of'· I"

. " ," ~ ,

. ,

~ .. - .r, "

. .

01.' .

. ~

\

....

··'·'·'4·

'- .. : I

,. .

·iii·o·niP "-

ll:,' .IIL'b i f '131

~

re-:_eUl,:1~ e

,-

nlD: -:~cNJ.,

(- e- -- -- --

" ~. I

. . '.

- ;)', ,'", - "

"

•

hvreid la' L~ -- paratl .. , roid gland - ~ s-'-nl .. ;a·,':~_,~- tie _ ~ ;', <f\"i:'-- tru -'k

..... .'

~- ; ·.,._ .. ,C~.

:·~.f' t_

g.

',-'

~D

e

,I

! -

"""'""Ii'

o

u

I~

I"~"' W\'jI

-

"
!l;iiiIIIiiii
,m'
~
~
10
-
e ~
,,~I IN
cDi U)i
,s------:riil ..

rn

,.~

c:

"O[

c o

.

!I~l

m U).

.~

[s-

, .. -

..

o

- f!

lliliiliiiiii

I~

'E, .

3' ,2:

, ' , '

me

, , ,

" .. _ .

'l'ml " , i iLk

P!retrache!lil'-1 .'_:_ )" ,~'~~-id_~" :e, l.a~e{'

.el ,-

,(-' ",

l,:

trom

_" .. - - . '

C.-_:rotid B

, tb

.-

n

, '1I!'lI' ',,' [ " 0 ~!I.!I!, "~,'_'

I I

~

"j ~ C,Ul~

~ .I"_ l~

_, ,!l1iI:','C. -iii _' ~ ',' ill

u..~ , iJI _ ~ 'Ill ~ I

'~ ;

i "C111I ~~-

J1j~"",--u.! ~~,,"

..

,If,

- -

:','"-l :i"::r ,_', ,~e

Pi: -: ant ;--

re:

...

. .... '. f,· ,C '~r ".C:~le~i. :" .'l th ..

..

.. , '. ,

. "l

d n

n[U~U~ .. 1,1" "

.J] .

c C
10_'
!P~
G)
,
,
~
0
[
!II' - s
01-1' ~ I :::Jil
I " ._ [(0 -_
•
'"C ~,
~, :l -
-
...... ' b
~-- c:
~ ~
~
E 1 -
~ c
,
~'
!
~ r}) .-~ m «'
~'"l -
1 I --
[e
I_:_
O[
~
, [
C .-.. ~,
£il[
[
~ !II-- QI
WI Q
"C ..... - L
Ul 0 ~
fiji WJ
E , r'
U'
~-
-I OJ
~ ~
.:J :J ~ ~ ~ m
'"
u
J:: .c ~
,m
-u I~~ ,t:-
....
0 i - m:
~~ :J
.~ JO' (.) !I!:~ UJ
I
-~! -:;, .; ._ I~
en! U'J' n,
: . ,
::Ii _,01.:_1
Ul s
--
, • - __ o. I

"

u:

,~

~ IMrA V'~I

3_2---;,

.

. ,

,.....

ft'!Io !iiIo<I'

,--

~ "-"'

0, .It i~

'"C

.. -

o ~

, '

, '

til

3·

18111 .- . rnl a~. ,~ ~ '_: r· .. · ,1m ,~In· I h·· , ,~ I~-))It'~' ifl!!'r ( 7,,,:

, r ~ k'i J.I. ,[1]1 -t __ 1 ll~.lIP, 'i,· -t ~ II ~, "

·a~

- - - ~

_. I ~:_I

Ild[_IC'~' ··'1' mlidp ~ ... ··iln·~, I~l;_

~-~~~,-. ,18.'t1lmlu,S, is,bllenll' 111D

-ig ~ II ~I ,2,~ 11<~lj I~'..-!a[rml_ '~_I---.'s'li::-s 'lhyriD:i'dllg~andl !dlelv~OIPI:~lent Nlone alre of cl!'i[n~cal :s;igl,niJl]cBln'C:Et. b:_ I 'I'~ai ~ prssls·nce 1m eoncer . :10 'lh'8 SUllflQIIBon ~

1(IBy ,_~rrni!SI,h:Jlnl j'-'j' JE :S)k:~n,~ '~_~:a .~:s. IGlrla'l~ lind ,JR: RO'_~I-~ A,n,-~)o_.' _!I

c-·O····! I ·,"'Il'··'~-- .. n-' :.' .~ . -S~,~iIi,lFi- 'IN' Yo .,~ I:('~ ... ' .C· .·~·rl·.' - \ .. ~ il· 1-llcg~IBI~!)1

_ - . I ,.,.' _ ~ , , _ _ a: _ . _ iLl ~'I' _. ·'11' II II _ . _- t 1_ ~ . _ .. _- \.:II. _. . _-!.::J 10' ,

'1-, i··

In i

_I,.fll

'I!!

_:_ rJI_ ... ~~

i ,, D,_:_ __ D

·llh. 'dr .MY

" 7'

i :

I . .-

[~ •. ,I'

-

4

""""""""'-NWIClO~ 'Irr,n_'-

Figurls, 2,~ 15,. Thel,ln:emb!U SUIPplly tiD 't:he 'Jhyrlo~d ,= 1,lJnIJ,. Thai :hyroi'd ~ -_-8 l.r:-',lllry

is ID:nl:, r ~ IQcca,siio,nall,' )1 re':S8'11i1'_j't i.IBy pe'rimiiss!ion of 8, - rzinluli D'll!'lDIUI'jasl~

Ha~ll: I'-'is!. el il,11 ~ ~ ,; :-m I - :21( '91',:6 ':~'I 1 !9i~'6; i ,',

.~ u- , I' :-","'iIi '111 ~lIi -,, 'II, -n~

'Ii; I,~, .. ',' .,I,g' ,I.

t- he I, ~ 3 ..

- I _. ._. __

"n",

1_.11...,

')-1- ~

- . - . I

_',',J_=m

t

ache . "_ ~~, II _:_,,_._~

1111

I 'I , _

AnAl 'B" ~. ~ e- '._ v. ,_ .. ~.

Ii ii=lil

, I -I' , , I 'I'

'" ";,,'1

" I, - 'In;-fiIl-C' ,I _ ,lll

'1\, in

III ,I.!!!""!.:_ I

, "

,. ,-

,~ b

U), '1- ,~I

d-

- .. 17' -:

1

-

,

I,~ T~"

i!Ji ~l~"

,~ii~h~ I if1., ,

,JOim~

'-" ~

I' ,

.• '~ InJd IRJ'r,c', I , rl," I~ " [Llcrv)'~:'g" ":', I, ,I "'Id ';"lli_J

" '

.rna

m, ~", " ap~:-' "f "

_' ', .. , ',:C,:, '_ ', __ ,,'

,~ ,

..

,m---' "

" ,

~iIoi. -.~I

,.'

',,' '1'.1'

~,

~' ,

'I' tha

I

'"

I 1

Sup'.

~ _-- ·:yftG_ . ,0 I

o.

D.

i. '.,

,A

'··m

'._ )1' I. 'L', iIoi

43

' ,

Su -1" th'y'rla I'dl a~

S,' _p~ h:lyn,~,_"_-_ ~l _-_~ A,~ i n-'er'nia~~~'

B .. -;xt

Ii

guor

I 1

'z···-·

" ..

""""'-' [

': ..

[, r

.. · .. r

, "

. he

".ll .

nl -~I_'II

b.'1 .,

'.

-,

e pr .. ,ih

'_f

, .'

.'

,"

~I h

',:,')")['-

· .

__ !_a[~e;

.11: --

... ilnill .llll],o.' .

'3

,Ii

ViSCSirB.' Comparlmeinit ,u.nder to

,.0; - - c . - ~,. .. . 'If :'1"-:'

~ ~I.t. I /. ~ ~ _. '. "' P. - _.

[iii

.··.~ri;

.' r ~,,~ S!s~..: pi

p iI r O'~ l;d ~~;a !1H:~

_J!'rv,_~i .'

_:,ftj"'j '. A', .

" .~, .. " ... - [~.

[Hi i~ 1 983·~)

1'"-, :

, .

ii

~'fII'

.Li IJ~ iij!

,_,I~. D ,I

~ d, ·

[Ii

'el •

'. rii"~, .

. IU~lIJ·

~ II

nc ,"~-

,

, ,"

- ]~-

~, "It '~'I

. .r""

r·

loo

,,~ "" -" ~

-

Thea'ro"idl Bed

'-J __ -- •. ,_-.': .

,

me

..

;1;'

~' 'e

•

,

l31n,·: .

I

. he

" I )

II

11 .'. .

Ii ~'_, .

-J~-IUII' 2~2',4,., ILa'lle,rall'

!_"

- ,I~ SI' 0'1 'hi. :S_l~ Illlt

f~'e~"

r

. ,.~J

'8,,1

j "_,'

'r-' 'If 'I ,if'~, _, ", I ant '-"r-=' (,-",: :," ,j:ll-;;;, ," .;' 'in I, . ,'n' ip r.

" _ I~,~ ILIIL~, '_". ~_. ~' .', IU,II_ ' _'_','_ , __ '._ ',~' ~

r.I J

. I '

. :to· , ,-.. th -.,-(, 'b-

_ _ __ J :C _- _:f:::: I,S ,_:".' I,. , ,j

,rr'I '

iL' .~ '~~k"

, ~",,"'" .'",1 ",

- ' '

""~",--,,

- ~.. - - --

-._. ..-<~- .. -

"'---~":-""

-_ . _-.

-_ ". ..

, -

F-~-- ..

__ ~nure '2"--", 2''''''9' ",

~ -' ~-" !~,,~, --:- !

...

,I

, . iii

br,an1ch lof 1:,BCi all ~'II, ~ _1111

process IlyIV~'Wilgl

~~. IG r ')B'telr ai r'if::.:_ ~Iaf' nerVI'

~1~tUSCIIB

Calrt i 11,lg1II a'~: II ~"·:,Ie .nl. ' J au: ,VIOl",' c~'_nla_

I

\

se

all ~ugul.,' v'lin Gr ater IlL ri'CUII." ~'e~' I

F' -1- 'g .. -U' -11'8'-' I f') 3~' o:=:

. ".~ ... ~ IJ <_.1 I_£d~.~."·,,

. '., I

i·······,U

. ,

th

'~ ~.

.1" .'

'.1 " ..• 1

·.I!!

,J~I' '

= .. iii

"

:._: -,[_

'-L

:l~!

- " 1 , th.
" n It· 11 -.~n,'"
- , il.
- !jJ ,!IIi

.~. '.' .. -.

I

I..

n .. ,

"- 'h'

..•. 'ranc .. ',cs",

.'., ,.'

,·il l .,

he

• I .' •

,j

I-iii" . 'iii .It A.' I ' .. -"

. ~_~ . 111.1'· III til Illl

'- '

. r'D'I'~

.. .. .

I .: :.' ._ '__:_. _ .. ....:.. ,

asseter l'e~IID

w .. 'I . _I . - - ~~ - ~

o S'IS Pi IID"-:,I ' .. ' pla~rot~d IP'Ds'-~elr"O(j , ,.oia,1 Visini (leu',')

E" tl' .rn,at jUlgu Is" ~ -I -.J'_ '-lfISa',IJ : .uric;ul,sr nl· J'.~ s' (C1u'J

F" -- -- 2" 3"'1 .. ]

~glIU '18' ,,'., II s

,·:·",·,ti p'" ."

" .J, ~'. • l.~

o

. 0:

rn re

'.

];["'11-'10'"

.i.~'ll.. ,~,

1--' '. ,

. _!iili

\

•

I

t

,

I I

l.

I - -.

l

I

I

~ ~

I

4

U\J~'l.·

-'h

. . ," "

I' _ ~.I ~ _.' I.~"'~ .'. .

.~ ~-~ (In IIJJJP .. · ard CO'n tin - a . ~! .- ,no ,,'

F-- ure '2:i .' 2' ,

~g .. 6 .. ,,' .

I /

/ j'

r

r

r

.J'

,
..
, :.:..r
..
.. ~
, •
1 ;,
, 1, ~ ..
I ",' \

•

~'gl_~ •. e ,2:~, ,3

~ ~
I
'" ~
1ij I,
\.
"
,
..
~ ,

I

.I )

I i~

r ,/

~ ...
~ ~
~ I
~.
I ~
Ii
it. ~
iI- ", ...
I
f
'"
.. Lin D' eli

C'" ·.all~ --(,

1,~,,_JO_~u SlI;' ,-,a" '_I

Fa'Beia, 0'11 'tr_, Ingl sp~_'n:ius, ImUISC e '_~-;d ~!e'Va:iCl'r ,S-II'- lIe I'

_ , , '1- - -

u 'el-

_-": 1

enor cl ~,-

1Jb'_ ..

, enc

____ J._ 11_ "_.

OJ

1"'Il...:-, I~-U~I'

U,I_, 1 _

,~

'"'

Ii

EJ11 ' rg--.

"

l" I I,

, '.~ _."!1!!3

l!if

. i

. !Ii

,. -

. iii

'I' ,.1..,

-=.' .';. i .,:~ lUI.'

! .. _ •

llilJ

I .. . ~

I 1

:1

o

........

lUI

Ull :J

E'

U) .:1

IW IW 101

((< - (' I a

' .. ' ----//'-

~ "'D

~ ~ c::

--

1m

,_",,;;,

Ie')

c

E

~I.1 L

.1

M !!.y

..........

r:n

'''T'''nI ~

.,_

~

o

~

m,

1Cl..

D-

.

......JI

iiiiiiiiiiiiii

iiii'iII' !!.'WII

ltD ifni

,iiii""'iIi ,_,

11}'1

S-J'~'~US a flrl e r le r

3: rl J ri~IDI S'~:elrnUlm

p'

1- ~~I' -"r'a'~'1 ,:la'~,II-

~I~III""~ I'"J

--=::-h-

, _-_I ::.. ••

'd' '.:_: ~ ..

':Id- 'II,~ I-' . 'm-- .... n-'::-"-'

~ .. ....:..___, .l~'1 .I._:_:._ [_1_,' ~.

!'

m~ 'ii

'" ." 1.I'g ....

- . _. liIJ .. _ ".

nd.

.... I!'

.. !i!

:~ th··- "'."

L

d

....

b,

.

"."--_."[

- .,-.

. -.

'. ~. • J

. _).~ . III

.. _ i. ·:h·· '.', h·· .. [1f"i' .'. ",_~[~ 1:··U.,lg~

',': II_ .' ':.' I. """"_ 1.\1."-". " ~&;i.

.. d il '.

: -t·:~ m : .

··H·

- I.

ev

'f •

' ..

B.

P·'EIlc·1

.. . 111-

.. ' ~-- _.,

IW Co .

Su

@

F·~glure 3~,2,~, 'ToIPogtr1ap,h'y oil the ,axjill,a,~ I tel,F'icIF' vie, -',~ I ·By permission of JI-" SI-JI,nldaba,~::_isl' S-~:_-' IG1r1aYI B __ d JIFI FlID. '_'B'j ,Analtolm~;call Ca.~, liics1tio,n,,',in11fJln\Sral S'u. __ lelr)fli-:- e: <' VIO : 1-, '--lcGI~a' - -_ Hlin" 11983L

Iili

~

IIfriI It '

~~ 111 '. 1J.1 ._

h ~,_

,_.~ Ii" _ iI~~ I.,_il'

I' I. ~._ .;:,

i!!!1

Th--:- -j

~' !-' • __ .-

m-

nectin ·

1,,]- -. -.,

IL. J' ~ •

I!;I '!!II

11.;;- _ 1_

. I Iii::_. Ii

Ril'trBict:edl ax i Ihiry mSlrgin

t· ~ ... 0 ,~~·-IAr,'SiI.~ ls mall'D"

p~c ,U'_ u. ~ . _

,andl m i ~ a:r')

S"rr 'IU~5 I _n~e,rior Iml_'BC~1

I-f~~ :~L~ jlai bOlflch3'r ID'f· I,j SI imlltl s d 0 [rei

ml 1=

l.-'ligllulre ,3,~6!~ 'TIne "'lriangulll,I.lr bed ,of ,s modl'filed , .... di:call.' , [,asrte·cI1omy,. ' e' plelolrallii'l, lmuscllSI I.~. ret ~ac'Jad-J _:,a-~" '_ar '11han f,smIOV'II .. .: .. 1(- '·~IO.,·' i"fihld b-,' perme-

• I IWI '1'1Li 1 - ,0. -. -0 I~ d JE S-k .II I 11\oijI!~ 1'- S-·

11~lnl 0111 _-~' :~,ftJ~~1 .-: at·L·,JI'jl _. ~,III._-.'-_n I anl,= I~_:_ ~~ _.~::~ .nl~,I-: I\JS11 eil ,~ l, I _. ml·~u'rg

,4,5.'91) :5- -,-5551," 19119~,:1

h ~ il

, " " I'·.I',·~' (.·1

.1 .t

.:- . r I ',If· 11"11..." ' 'II, tissi . ··U·'

" __ 1_ _ I U~I_ 1._ J ... ~ ill 1;"

-' U'I' 11- .

_ __ "i,l' I.~ . I;;;

I· ,.

. "

'] '"

_,1.1- '.'

I r- .....

'. n i;1

,I '

,111

"='1"

. I' - .

1 • •• •

" .. _ ' l_~

th , , :11 ".

" I'

- -

~

II.. ,I !

~~ 18 .... .I!. ,I: .!l

" .

m

if'Ni' Iii' .' I :'I-i~[~ I.~ '~'_', . ~ g~.

··f·rh.1 U Id,_

;-'.iIi. I',.; ··g,b

,; f"

_',- ,

e ' Iii

"'

'. "

L " B'Slon

. ~

. !Ii

'g'

l •... r "

-'.-.:

r·:£1.-:.·. 3-': ....

~ : .. l r- ~~.

1

II

)

/

..-

~

..--" .,d'

./ ,/'

/

,

.,i' A",cr ...... /'

-:

~/

f. ,

i ~I I' ,I

! • 'J

f • '

/f! (1,'

,.11

J

-', 17'

,

-.: , "

I, iii .

.,

,g~: ~ []I.'

" "1'11

_ I*; 11:.1.1,

ii~" " IJI '

'ii'~ UJII,-'

I 1

l2"· ~

. - ,,-

-

tr iw

, !'IIi '. __ [J , .

" I

~~"'i!Ii

'IIi I'h'

~.!& i!;; Il.

'If' - ,

l I J ~

•

~~'. '.. --

. .,

rs n ..

i i

13'"

'. , .. '.r J

I .-. ' . ~

~. .. ...

Iii i

th: ! ;,'\'Inl.· .. iir3i'~, c Ol~~ '~;~1~"', cten [,!~ ;~·h'-··-·· p'-' ~Ib;;~c"_ ",~,- ';iI:" p'lr~-' ,,'n·'t' [I~~ 1,101:-:-:0,; '··r'Il'''!'~ " 0,."'·'

, . ~UI'!I!. .~, . ~ '. tl . .J •• ~ I. ... ' ",' ~\ L '.. .J lJ~l" 1'.~iII!I! Il ~1~'1 . _.~ ~ [I. 1.11 &... _ ~_ ~~.. . _

- - - - - - - - - - - - - - ,_', ~

~nd'i vi ~'_c ,at' an .~ .• ~,,;: fused with th. ' transversus abdomi ,is [

I '~ Ii' ~ '.

, f,aus ~.[·,--JI!S!~!~ 'a~ C~ 3 ..

[I n~ e!rfov'eO~llr L~gai ::8_ ~,Hls!:se-- b __ ,c[(~')

" ; J.~ is not ,3,

'l i,:-I is Ion led by apot eu otic '1~ •. , rs from the i[lf;~'ri' r cru: of [ll,

na ri :1; ,I '. h ~:h Il[ tss I'U t . remediallv to the Iinea ,dl h,a~

If ng

I rlan~ veNljs '11'~'5Cr:1

II!----iiiiiiiiiiiiiii- ........................ -'tm ~~iiiiiiiiiiiiiiiiiiiiiiiiiiiiii~~ ..... ·,1

I I

'II ~

I!

,
'"I

'II
'tl
"8, Fli:gluF'e 14,:111 ~ This Ispa,cII 0'":' BOQlros,,,, 1 .... i"'n,omii' ",'_-1181 '1'~'~ICiB~' 21 = ,.1 r '~lla[1 ,obliJque

la1PonllilUIJOsilr 31,:: li'n'la11r1na,11 lob~iiqlUIII J_~,U,II''''

C II" 1'.1 ,4"', ~ , 'r'\!Iln~e~ 8'1 -1~' U- I~i ,:' ,,', '01 - r- ;, I'" ~ m" r- - -e!!C,'~ I -, I ~i

!I"I !.!iiiiiiiiiiiO "lg,,~,"',~I,~I, "_'" ~,'i!i[Ii ,~'~'-III

5 =: 'iIl<ll",B"n' ~v,'~rl~!allll"~il ,II"~I~~~,~ 18'" 'n' 'Ii,e' i~~r'i' I~' == ~\oi!' ...

_ 1III , ,i!3, ~ ~__,~ ~I g~ I!Ii.ii; Q,_ __ _ ~u II 11 II!J ~!ft

~8rli1'~, I "IP'Fmlla~:c ".:as,<~ r- .'; 7' .... , Ca,opel ~'ISI li:- l~' ,am!en'l~ 8 ,= r,u)b~c bo!nle'~ 9 = pe-cljn,.-' 'II mu'sch91'~-IDI = Irl8nll- -.'Irsslis! " '_ Be"Sf" 111;:

, '_ '~" , '~I '_ '_ '__ . '_' .' "_' I '_' __ '_ '_' ~"_' .'~ ..

'1IIt~IIi1SI" e 'saUsl 'I'als~~,ia u ,'Ii:DF' I~a[i iln:';; '_12 =, vessells':' 1131 ': ~e ,·'irlonlr_ m;: '1,: ~ lhamlle (SlP,&)Cle 81 plroslh'l'sii,er, soaee IOif

'-,:', ,,' lilOS; 151 =: p': 1.1' !rillO' " ',.Iat;- 6 ,~-

tlralnsvle_'susl lalbd1omilnls, apo:neuirosiiis Iindl Bini riID,f' ~Ial- il· II 10: '~~nslvllirsalis 'Ii,'~'scilai'

,- -, ,- , , .. - ., - ," , -, " -, ,I

" <7' ,= ',:II_-.-=-:0Ir811 alRlsry; 181 =: 'fla'morla~ vein,~ I(B~,,· plrrn-·.- iI'ss,ilonl 10lf JIE_' SI('alnldalla-'i:s,,- Gill, Co,lbol ".'1 JI, I ,An ,: lira ,- :,~ ·'islll e'~l at III S'UI ICltn ,II'D'_,I 7,3(~) '~'7'19,· , 361'1 119 -lu)1

, I

· 'ige-- '12. D··I,i I ,: -, 1-- 0' UlIB "o'sl rel-

the latera .. ·~-,n··_. , __ --'~Sl ,0'· th

-

........

..

•

""- .

- -

"ii' . '!!~ ~.l ~,,,,l~'

'~~ .-~

~

_.

~

. l~ •

[Fit U.~lr

...

or' lIP g 151[' C ';I-55' Is dl

F'":gIUlf'=1 1----:'~2·:~., I", J Icill', ['I i I_g ,-: ~I ,I _.lC:_ II ~ 'iDI_I'U{-h:, itri~,IC::. a '" Ug -lIml.I' 1'1 Df:

C~=p~r' can bl 1,~I,~~_~'FF1olm_ cllbo'lr1n 1= LI S,lkatnda lak I,l, JE:~ Lapla~Dlcopic:

Ica'd!srv'lerm'c ana l'fDmy of "Ilnsl 'iingulina.ll area, ,Probl 1(1'III_-_1 ,SUITg' 1 :2(1): 1 ~2:'O~ _] QQI51,~ ~ -- Lh I ~- [-lmils~'iali1~)

-ldi' , J rm

~~~~-N---~~~~' frans~=rs_s

.. m!"Us _ ~c

roseo lc 12fl( 11 l: 1-'1 ..... 2,O.~ . 9951-

(_ I~I
.-. I f·.--
lID 10 I
~, 0)
l -
- -
U I~' ..._".
iD C-
O R'- ~
...... itII ..

-

II;

E

!

C (, 'J

~
-_.
~
Ill::
E
'"""", 'Ii)
..... i'
01
i. U
,.,
CL
D ~
I
It) I~~I I': II
- 1 01
01 01 ...-...
'~, Ij!!
Q I
iii: Ie 2
-
~
I~
., III
U 10
.~
D U
lUI
Ifl!
::iI
Ie. u
IQ 01

E,

.'

u .fL1

Deep 'ng .. 1'11'··1 rig

-

Jli.!o ;~ u '-_ jc: Ir·. cl

,-

, '

.' I.' ..

nd e- 'e·s

: ' : . ', .. i _. i, ... '." _. . ' .

. I' ,I. - "'.!

F

-"n""'~ p

I . ~

'b-

~" '-'" JEll

come

, .

,

~. " ~

'v

e=:

[II'

. h ..

l . . . - ~,

t_ !i~_lr

iiiIi . .I 1.,,-

1.'--,' ',}.-

. "

h

il

_ I: ill

I 1

A

,

I '

I _ ,

II

'I H
I il
- J 0
i. •
~ ~ _t
.... 0' ..
-... -.~ .. •
I~ •
~ •
~ •
e
II
, !
~I •
"
" ~ t
" ~ • •
!' ~
'" i • f
"- ~ 0'
" ,
~ ~
~ ~
• "
e., IJJ ~
~~
~ ,
!Ii
t
- -.'
r ~ 4""7'-

I ,:

!!' '" :~. II!!

- ;J'

•

,

l' i

I

c

,

-

. ...

I __ ~ 1Ii~ ,,",

I) !!I

F

, ,t
~
~
[
0
iI t
i
• "
1 ~ ·
~ I ;
! II ~ ~
~ • " •
~ , • • "
r 0 • •
• I ,'I ~ JI
~- \~~ _'"
~ ~. I.?;
'LJ
~
,
,
·
. ~~ -
! ~ ~ ~
~ • I
'" • •
! , ~ • ,
I ~ ·
cj ~ ~ '" II
, • ~ .
I • I!i ' -
~ ~ !Ii
• !II!
~ " "
~ ~ • 0
! I' , J
t 0 ~ I
• - j , 'I !
\: I ~, I •
., \ i ~
I - ,
I I
J' , ~
, • "
Ii, Ya,r'"

, p .. 'Ir'IJ'c

,'. r ~._.

- l 1-

,=

'f' . ,/ .

: I'

ay ,,'''' I,: '11' mcision is always ,:L n

- n--

"~! .

. ,_. ,0"_

iii

,', - ~ ~'I, ~]. l:ll,

'.' ·S

I .'-!111-

, .. £'

).

I 1

f the 'lb·.

. 1'1>

~ .. I,

t,

,',. "

"

mO-'IIC' :~

~:pII~[ i~1

")_.

! _ 'I""!lI1

. ,~. I~ •

", '-b"

,. ,

,.,·r a

• [iii

'1-01 .'

,D1e,hiscenlcs fJf thl8 In'eision "i,',_ i Ie,

~" tU', .

,0 th

,~:,[' ' ..

in .1, \: .. ':_·I :~I., : inee O~, .. [' type i:f :,ur,6e",~,~,~ Tb~' ',I_? - .'~.~ ;

[

O;'raill"r~o/og,' and ~'.iltho·· ene.·.is

'u,r'g~:-''', : d .~hisc[-tnc~ :in' 'eerier 'I .' 'r anatomical . n~!i.: ~ -d'II:;. or tech ....

~

mque

• P,'," '::'0' '. "0" 1[;""

. ' ._. e· ."..~, .. _.~.'

Pi. .. .. ·-f , .. "'~: . ;,-," .... , . 'd'

, - I· .. 1' .: ~: I" :", I _ I' . '.. 1, "..":' 1 . -" " I

" relap",ral~ r- ' ·v,a!u. ,.ron., ft.,

: astroin ':~l~ tinal an,:;. S~· nall bowel sene .. ,I~f indicated

• "', 1 i ., I'mi . ,,'. .. - " ; t .. 'n ,: t ~~ t . 'd.,

Y I .' '. _ ,II] ~ .1 ...... "-1. ,'. 1

, .

,I_ft .. _

!o'

t ,~U. ,-

.. ct .

1 ',._~i.~_ ..

5B 0-3 7-9 2- I