Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . nflammation, the operation of cecostomy may be done instead. Whenthe appendicostomy has performed its service, the opening may close spon-taneously. If it does not close, the wound may be opened as before, and theappendix amputated at its base as in appendectomy. Cecostomy is done for the same conditions as appendicostomy. Of thetwo operations cecostomy is to be preferred. The approach is the same. Thececum is brought into the wound and a point in the anterior lon
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . nflammation, the operation of cecostomy may be done instead. Whenthe appendicostomy has performed its service, the opening may close spon-taneously. If it does not close, the wound may be opened as before, and theappendix amputated at its base as in appendectomy. Cecostomy is done for the same conditions as appendicostomy. Of thetwo operations cecostomy is to be preferred. The approach is the same. Thececum is brought into the wound and a point in the anterior longitudinalband selected for the opening. A valvular opening is made after the methodof gastrostomy (page 731). A purse-string suture is cast about the pointselected; and another similar suture placed around the first. A very smallopening is made into the cecum, and a catheter inserted through it into thebowel. First the inner purse-string is tied, and then the outer, in such a waythat the wall of the cecum is pressed inward making a teat inside of the bowelwith the catheter emerging at its apex (Fig. 1227). The ends of the two. Fig. 1226.— appendix brought out throughabdominal wound and cecum sutured toabdominal wall. THE ABDOMEN 573 sutures are secured to the abdominal wall and the rest of the wound closedabout the catheter. Irrigation may be begun forthwith. Adhesions arequite firm in two days. C. L. Gibson, who described this operation in 1902 (Boston Med. and , Sept. 25), and whose idea preceded that of Weir for making a cecalfistula for colitis, made a simple fold in the wall of the bowel by applyingtwo sutures and then a row of four sutures folding under the first two. A softNo. 30 F. catheter is used. The irrigations and dressings can soon be managed by the patient. Thecatheter is introduced and the medicated fluid is thrown into the cecum andexpelled by the rectum. Some of the fluid enters the small intestine. Irri-
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
