Operative surgery . l its upper limit appeared, then made an incision transversely across its anterior surface, goingcarefully down to the peritoneal covering ofthe returning layer (rf), then through it intothe peritoneal cavity, arresting haemorrhageas it occurred. The adjoining peritonealcoverings of the two layers (entering andreturning) of the intussusceptum {c, d) wereunited together at the point of severancewith a row of fine silk Lembert a similar treatment of the posteriorhalf of the surface, the intussusceptum wasremoved and the respective coats of theinner (entering) la
Operative surgery . l its upper limit appeared, then made an incision transversely across its anterior surface, goingcarefully down to the peritoneal covering ofthe returning layer (rf), then through it intothe peritoneal cavity, arresting haemorrhageas it occurred. The adjoining peritonealcoverings of the two layers (entering andreturning) of the intussusceptum {c, d) wereunited together at the point of severancewith a row of fine silk Lembert a similar treatment of the posteriorhalf of the surface, the intussusceptum wasremoved and the respective coats of theinner (entering) layer of the invagination(c) were joined with those of the middle(returning) layer {d) previously divided,except the peritoneal covering, which hadbeen already united as a preliminary meas-ure. This method not only shuts off theperitoneal cavity above the point of constric-tion before the intestine is opened, but also unites firmly the respectivelayers of the intestine with each other, thus preventing infection of the. Fig. 913.—The treatment of ileo-CcBcal intussusception, Baraczsmethod. Isolation of the tumorand closure of the divided extrem-ities. Enterocolie anastomosis. OPERATIONS OX vis(p:ra connectkd with im;i;itox^um. <;<.» raw surfiiceri and the consequent danger of non-union and peritoneal in-flamtnation. In a time of emergency in this class of cases a stiff tube maybe passed through the intussuseeptuni, around which the gut is ligaturedat the upper limit with a strong rubber cloth, causing it to slough away asthe serous adhesions take place. The IiesiiUs of (aliafoini/ for Acute IntnsHiisceplioii.— Out of sixty-fivecases in which the intussusception could be reduced, thirty-eight died, amortality of fifty-eight per cent. Among the children of this group, themortality was sixty-six, among the adults forty-seven per cent. Of seven-teen cases in which the affected bowel was resected and sutured, only tworecovered, both adults. Of sixteen cases in whicli an arti
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