Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . ns may causefixation of the sigmoid and give rise to obstinate constipation, which isrelieved only by dividing the adhesions and restoring the mobility of thebowel (Figs. 1252 and 1253) (see Peritoneal Adhesions, page 520; andChronic Intestinal Stasis, page 610). Ileocecal valve obstruction is not uncommonly seen as an abnormal tight- THE ABDOMEN 603 ness of the valve, giving rise to dilatation of the ileum, ileal stasis, and oftensymptoms similar to appendicitis.
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . ns may causefixation of the sigmoid and give rise to obstinate constipation, which isrelieved only by dividing the adhesions and restoring the mobility of thebowel (Figs. 1252 and 1253) (see Peritoneal Adhesions, page 520; andChronic Intestinal Stasis, page 610). Ileocecal valve obstruction is not uncommonly seen as an abnormal tight- THE ABDOMEN 603 ness of the valve, giving rise to dilatation of the ileum, ileal stasis, and oftensymptoms similar to appendicitis. Many of these cases have been operatedupon for appendicitis, and the appendix found to be normal. The treat-ment is highly satisfactory. An incision should be made 5 to 7 cm. (2 to 2%inches) long in the direction of the long axis of the ileum. Its middle shouldbe at the ileocecal valve. It should involve the whole thickness of thebowel wall. The two ends of the incision should then be ,and the wound closed at right angles to the incision which made it. Thisoperation enlarges the orifice and cures the Pig. 1252.—Sigmoid Adhesions, Causing Constipation, Which can be Cured only byDivision of the Adhesions. Diverticula cause obstruction in several ways. (1) The extremity of thediverticulum may have become attached at the umbilicus or have become ad-herent in any part of the peritoneum, forming a band under which bowelbecomes strangulated. The diverticulum may be so large that confusion iscaused by mistaking it for intestine. The extremity should be freed from itsattachment and the diverticulum amputated after the manner of removing thevermiform appendix. It is ligated at its base a short distance from thebowel, cut off, the mucous membrane distal to the ligature sterilized bycauterization, and the stump buried by a seromuscular suture of the intestinalwall. Usually this should make a transverse line. In the case of a small 604 SURGICAL TREATMENT diverti
Size: 1418px × 1761px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
