. A manual of gynæcology and pelvic surgery, for students and practitioners. Fig. 253.—Appendectomy. The mesentery severed. ligature if the mesentery is readily drawn up, but with a shortfat mesentery, or one friable from oedema, it is safer to tie insitu, snipping away as much as has been safely ligated. Veryshort stumps, and loosely placed ligatures and sutures, have noplace in the removal of an appendix unless one wishes to reopenin the middle of the night to stop hemorrhage. Care is neces- APPENDECTOMY 551 sary in ligating the mesentery not to catch the wall of the ileum,or kink the ileum
. A manual of gynæcology and pelvic surgery, for students and practitioners. Fig. 253.—Appendectomy. The mesentery severed. ligature if the mesentery is readily drawn up, but with a shortfat mesentery, or one friable from oedema, it is safer to tie insitu, snipping away as much as has been safely ligated. Veryshort stumps, and loosely placed ligatures and sutures, have noplace in the removal of an appendix unless one wishes to reopenin the middle of the night to stop hemorrhage. Care is neces- APPENDECTOMY 551 sary in ligating the mesentery not to catch the wall of the ileum,or kink the ileum at its junction with the caecum. Before the appendix is amputated the intestine and abdom-inal incision should be protected with sponges, else local periton-itis with subsequent adhesions, or abscess in the abdominal wall,is bound to follow in a fair proportion of Fig. 254.—The purse string suture laid, the base of the appendix crushed. Aplain catgut ligature in position to tie around the crushed portion. Many methods of managing the stump have been of the base, amputation of the appendix, andcauterization of the exposed mucosa being the simplest, andthis may be practised with satisfaction whenever drainage must 552 DISEASES ASSOCIATED WITH GYNECOLOGIC LESIONS be employed. According to some good authorities the samesimple treatment is perfectly adequate in all cases, but suchtreatment of exposed infected stumps would scarcely be con-sidered good practice in intestinal resection, and appendectomyis but a miniature resection. Burying the exposed stump in theraw surface of the mesentery also has its advocates. On thewhole, that method which consists of crushing the base with
Size: 1610px × 1551px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, bookidman, booksubjectgynecology
