Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . , eighth and ninth dorsal spinal nerves gives the epigastric and shouldermanifestations of stomach disease. The intimate sympathetic connections of the stomachmake this organ a centre of reflex disturbances referred from every region of the body. Exposure of the stomach is secured through the incisions in the upperabdomen already described (page 504). The anterior wall of the stomachis easily brought into view. It is recognized by its thickness, comparedwith that
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . , eighth and ninth dorsal spinal nerves gives the epigastric and shouldermanifestations of stomach disease. The intimate sympathetic connections of the stomachmake this organ a centre of reflex disturbances referred from every region of the body. Exposure of the stomach is secured through the incisions in the upperabdomen already described (page 504). The anterior wall of the stomachis easily brought into view. It is recognized by its thickness, comparedwith that of the intestine, by its being continuous with the great omen-tum below, by the gastrohepatic omentum passing upward, and by its pink-ish-white opaque appearance. The fundus is best reached by an incisionto the left of the median line. Exposure of the posterior wall requires division of the great omentum asit hangs from the greater curvature. This is easily done by making a rentin it between its blood-vessels, and ligating any vessels which may requireit. This operation gives access to the lesser peritoneal cavity between the. Fig. 1376.—Lymphatics of Stomach. Showing lymphatic currents whereby cancer of the stomach is carried toward the lymphatic nodules. Dotted lines show incisions for partial gastrectomy. stomach and transverse colon. Better access is secured by lifting up theomentum and dissecting it from the colon. Gastric lavage (washing out the inside of the stomach) is employed toempty the stomach of its contents especially when the contents are of morbidcharacter. The distance from the incisor teeth to the cardiac entrance ofthe stomach, by way of the esophagus in the average adult, is between 38and 46 cm. (15 and 18 inches). For washing out the stomach the tube shouldpass 5 or 8 cm. (2 or 3 inches) beyond the cardia. The cardia is providedwith a valve which prevents regurgitation of food but does not hinder thepassage of objects from above downward. The most useful
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
