The Practitioner . ces by bowel clamps, or the fingers ofassistant placed back to back, with sufficient interval short incision is made into the bowel, and a purse-stringsuture of fine silk inserted round the margins of the aperturewhich may comprise all the coats at the margin. The centraltube is then inserted into this aperture and the purse-stringsuture dra\\Ti tightly so as to apply the margins of the aperturein the gut over the flange of the tube. If for mere preliminaryenterostomy the thread may be tied in a bow. Then theouter spring button is passed over the other end of the t
The Practitioner . ces by bowel clamps, or the fingers ofassistant placed back to back, with sufficient interval short incision is made into the bowel, and a purse-stringsuture of fine silk inserted round the margins of the aperturewhich may comprise all the coats at the margin. The centraltube is then inserted into this aperture and the purse-stringsuture dra\\Ti tightly so as to apply the margins of the aperturein the gut over the flange of the tube. If for mere preliminaryenterostomy the thread may be tied in a bow. Then theouter spring button is passed over the other end of the tube,and pressed home so as to hghtly clamp the margin of the gut;and a long piece of indiarubber tubing is passed on to the freeend of the tube. The clamps, or fingers of the assistant, can then be removed,and the intestine will immediately drain through the tube into INTESTINAL OBSTRUCTION. 95 a receptacle placed below the operation table. The operationof the obstructing lesion is then proceeded with (Fig. 4), and. Fig. 4. Authoys Enterostomy Tube in use during Operation. after it is finished, the bowel having drained the whole time, thegut is again clamped near the tube, the rubber drainage tubingremoved, then the spring button. The bow-knot of the pursestring suture is untied, the inner tube removed from the boweland the purse-string suture drawn tight and tied, so closing theaperture in the gut, and this is reinforced by an outer con-tinuous or interrupted suture. The loop of bowel is released,cleansed, and returned into the abdomen. If it be desired tocontinue the drainage as a longer temporarj measure, the tubecan be left in and included in the abdominal wound, with somegauze around the part which projects. The intestine then restsjust within the abdominal cavity ; later on, the tube can beremoved as described and the bowel sutured in situ where itwill have become adherent. TEMPORARY ENTEROSTOMY. Temporary entorostomy is employed when the drainage ofthe bowel is to be con
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Keywords: ., bookcentury1800, bookde, bookpublisherlondon, booksubjectmedicine
