Medical Terminology Daily (MTD) is a blog sponsored by Clinical Anatomy Associates, Inc. as a service to the medical community. We post anatomical, medical or surgical terms, their meaning and usage, as well as biographical notes on anatomists, surgeons, and researchers through the ages. Be warned that some of the images used depict human anatomical specimens.

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A Moment in History

Jean-Louis Petit

Jean Louis Petit
(1674 – 1750)

French surgeon and anatomist, Jean Louis Petit was born in Paris in on March 13, 1674.  His family rented an apartment at his house to Alexis Littre (1658 – 1726), a French anatomist. Petit became an apprentice of Littre at seven years of age, helping him in the dissections for his lectures and at an early age became the assistant in charge of the anatomic amphitheater.

Because of Petit’s dedication to anatomy and medicine, in 1690 at the age of sixteen, became a disciple of a famous Paris surgeon, Castel.

In 1692, Petit entered the French army and performed surgery in two military campaigns. By 1693 he started delivering lectures and was accepted as a great surgeon, being invited to the most difficult operations.  In 1700 he was appointed Chief Surgeon of the Military School in Paris and in the same year he received the degree of Master of Surgery from the Faculty of Paris.

In 1715 he was made a member of the Royal Academy of Sciences and an honorary member of the Royal Society of London. He was appointed by the King as the first Director General of the Royal Academy of Surgery when it was founded in 1731.

Petit’s written works are of historical importance.  “Traite des Maladies des Os” ( A Treatise on Bone Diseases);  “Traite des Maladies Chirurgicales et des Operation” (A Treatise on Surgical Diseases and their Operations” This last book was published posthumously in 1774. He also published a monograph on hemorrhage, another on lachrymal fistula, and others.

He was one of the first to perform choIecystotomy and mastoidotomy. His original tourniquet design for amputations saved many in the battlefield and the design of the same surgical instrument today has not changed much since its invention by him.

His name is remembered in the lumbar triangle, also called the "triangle of Petit", and the abdominal hernia that can ensue through that area of weakness, the lumbar hernia or "Petit's hernia".

Sources:
1. “Jean Louis Petit – A Sketch of his Life, Character, and Writings” Hayne, AP San Fran Western Lancet 1875 4: 446-454
2. “Oeuvres compl?tes de Jean-Louis Petit” 1837 Imprimerie de F. Chapoulaud
3. Extraits de l'eloge de Jean-Louis Petit Ius dans Ia seance publique de I' Academie royale de chirurgie du 26 mai 1750” Louis A. Chirurgie 2001: 126 : 475- 81


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Billroth II procedure

The Billroth II procedure is a variation to the Billroth I procedure pioneered by Dr. Theodor Billroth in 1881. The procedure is a a "subtotal gastrectomy" where gastrointestinal continuity after the resection is attained with an anastomosis between the stomach and the jejunum, a gastrojejunostomy.

The procedure was originally performed as a way to resect peptic ulcers caused by hyperacidity. Billroth removed up to 70% of the stomach. Modern variations of the procedure are less agressive, resecting only 50% of the distal stomach (a hemigastrectomy), or an antrectomy.

The reason for the Billroth II variation is the difficulty performing a gastroduodenostomy. This can be caused by a short abdominal esophagus, a short proximal gastric pouch or other reasons. The accompanying image shows the digestive tract before the resection. The area to the resected (specimen) is grayed out. If you hover your cursor over the image you will see the completed Billroth II procedure. 

In the completed procedure you can see A: The stapled-closed duodenal stump. B: The gastrojejunostomy that allows passage of food from the stomach into the jejunum, and C: the staple-closed gastric stump that is not part of the gastrojejunostomy. Bear in mind that this sketch depicts only one of the many ways of performing this procedure 

Image property of: CAA.Inc. Artist: Dr. E. Miranda

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