The practice of surgery . mes nausea and vomiting, chronic con-stipation alternating with diarrhea, and periods of obstipation, relievedafter a time, but associated with intestinal disturbance. These attacksare wont to occur with increasing fretjuency, and if unrelieved by treat-ment, end eventually in slow exhaustion and death, or in a completeand alarming obstruction for which operation is imperative. The treatment of chronic obstruction forms an intricate and im-portant chapter in abdominal surgery; briefly, it amounts to this,that if we are dealing with a patient giving a long history of d
The practice of surgery . mes nausea and vomiting, chronic con-stipation alternating with diarrhea, and periods of obstipation, relievedafter a time, but associated with intestinal disturbance. These attacksare wont to occur with increasing fretjuency, and if unrelieved by treat-ment, end eventually in slow exhaustion and death, or in a completeand alarming obstruction for which operation is imperative. The treatment of chronic obstruction forms an intricate and im-portant chapter in abdominal surgery; briefly, it amounts to this,that if we are dealing with a patient giving a long history of dyspepsia,occasional pain in the lower part of the abdomen, with nausea, vomiting,and constipation, recurring at intervals and with gradual loss of fleshand strength, we must operate to discover the cause and remove it ifpossible. Bands, adhesions, and external tumors must be to the intestine itself must be repaired by section of the boweland excision of the diseased portion, or, if the patients condition is. Fi^. 20.—End-to-end anastomosis. serious, we must content ourselves with the palliative operations ofmaking an artificial anus or performing anastomosis. So much for a general consideration of intestinal obstruction,acute and chronic. Let us now make a brief study of the special in-testinal lesions with which the surgeon is concerned. INJURIES Injuries to the intestines commonly are of three sorts: (1) sudden blows; (2) those from crushes; (3) those from penetratingwounds; and in all three types of injury the damage to the intestinemay be out of all proportion to the apparent violence. I do not in-clude here foreign bodies which may cause trouble within the , the intestines may be niptured by increased tension fromwithin. Blows and crushes may injure the viscera without greatlycontusing the skin. In such cases one finds ecchymoses of the gutand of the mesentery; tears of both; free blood or blood mixed withfeces and gas in the periton
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1910
