Preparatory and after treatment in operative cases . ld be carefully executed,as any trauma to the seat of esophageal obstruction will rendersubsequent infection of the stomach wound more likely. Imme-diately before the operation and subsequent to the last cleansing,enema, a nutritive enema of peptonized milk (cold process),should be given. Severe manipulations in the region of the anusshould be avoided, as it may be necessary to nourish the patientby the rectum for several days following the operation, and thismay be seriously interfered with if the anus be irritated. Theexistence of persiste
Preparatory and after treatment in operative cases . ld be carefully executed,as any trauma to the seat of esophageal obstruction will rendersubsequent infection of the stomach wound more likely. Imme-diately before the operation and subsequent to the last cleansing,enema, a nutritive enema of peptonized milk (cold process),should be given. Severe manipulations in the region of the anusshould be avoided, as it may be necessary to nourish the patientby the rectum for several days following the operation, and thismay be seriously interfered with if the anus be irritated. Theexistence of persistent cough is an objectionable complication, 481 482 OPERATIONS ON THE STOMACH and should be controlled if feasible before the operation. It iseasy to see how coughing would interfere with union of thestomach with the anterior abdominal wall. If cough be presentand the operation be not imperatively indicated, a slight post-ponement of it is wise; if, however, the condition of the patientdo not warrant the delay, it may be necessary to administer suf-. Fig. 305.—Tube Leading into Stomach Following Gastrostomy Held in Place. ficient opiate immediately after the operation to control the symp-tom, and this may have to be maintained for several days. It is,of course, not a desirable indulgence, but is in some cases thelesser of the evils. The operative technic most commonly employed at this writ-ing contemplates the formation of a valvular opening into thestomach, this viscus itself furnishing the valve. The wound isquite closed, except for the point of exit of the rubber tube to besubsequently used for the purpose of introducing food, the usualprotective dressing is applied, the tube, which should be 12 to 16 GASTROSTOMY 483 inches in length, is led out through the dressing, and after beingclamped at its distal end is held in place with a safety pin (). The feeding is done through the tube without disturbingthe dressing, which latter is, if there be no indication to thecontr
Size: 1408px × 1775px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, bookpublishernewyo, bookyear1910
