Transactions of the American Association of Obstetricians and Gynecologists for the year ... . re-fully dividing bands transversely and suturing longitudinally, by 301 302 WILLIAM SEAMAN BAIX BRIDGE, flaps of peritoneum or of omentum or skin grafts, a surgeon can curemany a case of distressing adhesions. 5. Early adequate attention to bands and adhesions in the rightupper abdominal quadrant often makes such operations as cholecys-totomy, cholecystectomy, and gastro-enterestomy unnecessary. 6. May it not be possible that by a just estimate of the mechan-ics of the abdomen and careful attention
Transactions of the American Association of Obstetricians and Gynecologists for the year ... . re-fully dividing bands transversely and suturing longitudinally, by 301 302 WILLIAM SEAMAN BAIX BRIDGE, flaps of peritoneum or of omentum or skin grafts, a surgeon can curemany a case of distressing adhesions. 5. Early adequate attention to bands and adhesions in the rightupper abdominal quadrant often makes such operations as cholecys-totomy, cholecystectomy, and gastro-enterestomy unnecessary. 6. May it not be possible that by a just estimate of the mechan-ics of the abdomen and careful attention to the lessons learned, wemay better order our lives from the beginning and so often preventthe formation of bands and adhesions, thus obviating their serioussequelae? Case i.—A. M, aged thirty-one: female; single. First seenNov. 29, 1916. Chief Complaint.—Bilious attacks during past two years. Atfirst these came every month, but during the year previous to myseeing the patient, the average was one a week. Attacks consistedof general malaise, headache, nausea, and vomiting of bile with. Fig. i.—1. Liver. 2. Fundus of gall-bladder. 3. Bands from gall-bladderacross duodenum to gastrocolic omentum. Traction on the transverse coloncaused these bands to stand out. the gall bladder to be pulled downward, angu-lating the cystic duct and compressing the duodenum. Practically, the trans-verse colon was supported by these bands, and the dilatation was proximal tothis point. 4. Ascending portion of duodenum distended. 5. Descendingportion of duodenum not distended. slightly yellow tint to conjunctivae. Xo pain. Any great exercisein the upright posture brought on an attack. Marked an invalid; unable to work. Physical Examination.—Resistance over gall-bladder: tendernessover terminal ileum. Poor general condition. X-Ray Examination.—Dilated ascending colon with ptosis ofhepatic flexure. Colonic stasis chiefly in ascending colon. Treatment.—Six months of
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