Surgery; its theory and practice . en, dividing any stricture if necessary, {d)If a volvulus is discovered an attempt must be made to untwistit, and as a prophylactic against retwisting, the mesentery may beshortened by folding it upon itself parallel to the intestine, andfixing with sutures. If the volvulus cannot be reduced, the con-tents may be let out, the wound sutured, and another attemptmade. This failing, the volvulus may be excised and the intes-tine restored by one of the methods of enterorrhaphy (page 382).If the patient is too collapsed to admit of excision, the volvulusmay be left
Surgery; its theory and practice . en, dividing any stricture if necessary, {d)If a volvulus is discovered an attempt must be made to untwistit, and as a prophylactic against retwisting, the mesentery may beshortened by folding it upon itself parallel to the intestine, andfixing with sutures. If the volvulus cannot be reduced, the con-tents may be let out, the wound sutured, and another attemptmade. This failing, the volvulus may be excised and the intes-tine restored by one of the methods of enterorrhaphy (page 382).If the patient is too collapsed to admit of excision, the volvulusmay be left, and the intestine short-circuited by means of Sennsplates, etc. If gangrene has occurred, the volvulus must be ex-cised and circular enterorrhaphy or lateral approximation per-formed, (c) If a band is met with it must be divided. (^/) If alarge diverticulum is the cause of the obstruction it must be cutacross, and the bowel end closed by Lemberts suture, (e) If asmall diverticulum is producing the constriction it must be severed. Pauls glass tubes for drainingthe intestine. The end withthe double flange is insertedand tied in the gut. (After Paul.) 6o8 DISEASES OF REGIONS. Fig. 286. and the two ends ligatured. Should the intestine give way in di-viding the obstructing band, etc., or have already given way—ifthe perforation is small and the coats are in a fairly healthy condi-tion, the wound in the intestine may be closed by sutures in theway described under wounds of the intestine. But if the coats arein an inflamed or sloughy condition, or gangrenous, the diseasedportion may be excised, and the upper and lower portions of theintestine united in one or other of the ways already mentioned(page 382). Only when the patient is much collapsed should theends of the bcwel be iixed to the external wound and an artificialanus made. Before uniting the intestine, however, it may be wellin some cases to fix the intestine temporarily in the wound and let the contents of the distended po
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectsurgery, bookyear1896
