Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . ble to remove at once,may be treated by anastomosis of the cecum to the rectum. This operationmay be easily and quickly done with a button without suture. The THE ABDOMEN 599 small intestine, cecum, colon or sigmoid may be used. The convenientsegment above the obstruction is evacuated by a trocar puncture surroundedby a purse-string. After the bowel has been emptied, the upper half of alarge colonic button is substituted for the tube and held by the purse-stringsu
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . ble to remove at once,may be treated by anastomosis of the cecum to the rectum. This operationmay be easily and quickly done with a button without suture. The THE ABDOMEN 599 small intestine, cecum, colon or sigmoid may be used. The convenientsegment above the obstruction is evacuated by a trocar puncture surroundedby a purse-string. After the bowel has been emptied, the upper half of alarge colonic button is substituted for the tube and held by the purse-stringsuture, the lower half of the button is then passed up through the rectumby means of forceps (J. S. McArdle had special forceps made for this purpose).The button is pressed against the upper rectal wall, which is incised fromthe peritoneal side enough to allow the stem of the button to squeeze throughthe opening. Then without further suture the two halves are pressed to-gether and the anastomosis completed. A still safer procedure consists indrawing out a loop of bowel above the obstruction and rapidly making anartificial Fig. -Adhesions Causing Mild Obstruction Cured by Division of theAdhesions. Special Forms of Intestinal Obstruction.—Intestinal obstructions due tothe paralysis of peritonitis and to tumor have been discussed. Hernia is dis-cussed in a separate chapter (Vol. Ill, page 17). Whatever may be thecause of obstruction the first consideration should not be its removal, butto do the thing necessary to save the patients life; the treatment of thecausative condition may then follow in due time. Strangulation by bands should be treated by dividing the band. Thismay be a fibrous cord, formed by stretched-out adhesions, which is friableand requires no ligature, or it may be some vascular structure such as a tabof omentum or tip of Fallopian tube, and require to be ligated on either often happens that the examining finger breaks the band and relieves t
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
