Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . Fig. 1355.—Intestinal Exclusion by stump of the ileum and of the sigmoid are attached at openings ihjthe abdominalwall. A tube is placed in the rectum above the anastomosis. This is the^best oftheseprocedures. THE ABDOMEN 681 may. be made to this, but it is the safest practice. The only part of theintestine where regurgitation is not apt to take place is at the ileocecalvalve (Figs. 1351, 1352, 1353, 1354 and 1355). After resection of a segme
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . Fig. 1355.—Intestinal Exclusion by stump of the ileum and of the sigmoid are attached at openings ihjthe abdominalwall. A tube is placed in the rectum above the anastomosis. This is the^best oftheseprocedures. THE ABDOMEN 681 may. be made to this, but it is the safest practice. The only part of theintestine where regurgitation is not apt to take place is at the ileocecalvalve (Figs. 1351, 1352, 1353, 1354 and 1355). After resection of a segment of colon the remaining segment may beexcluded. Wherever this is done the excluded segment should be providedwith fistulous openings for irrigation. This is no great inconvenience tothe patient as the secretion from the empty bowel is very slight. It maybe washed through every day with warm water and thus kept clean. Ex-cluding the colon for chronic stasis is an easier and safer operation thanresection, and it may help preserve the omentum (see page 645).. Fig. 1356.—Exclusion of Bowel by Mucous Membrane seromuscularis is incised and separated from the mucosa by blunt dissection. Operations for closing the lumen of the intestine are performed, whereexclusion of a portion of the bowel is desired. Such operations are doneat the pylorus in connection with gastroenterostomy, and in the intestinebetween the points of an entero-enterostomy (see Formation of a Blind End,page 662). Purse-string suture of the bowel after dividing it transversely is the sim-plest and easiest method. It is possible to make this an aspetic operation,by ligating the bowel tightly, dividing it with the thermocautery, sterilizingthe mucous membrane of the stump; and burying the stump with a purse-string suture. 682 5 URGICA L TREA TMEN T Transverse closure of the divided bowel is done with an over-and-oversuture. Two layers of suture are usually applied. The division of thebowel is made
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
