. American practice of surgery ; a complete system of the science and art of surgery . Sic I ION \ I, \ih:\v Oh ExiicMsivK Gan(;r1:nOus In-iussusci,Iriox, Dih; ro an IXVKRTED MkCKELs DIVERTICULUM I^roni 1 )r. R. C. Coffeys Article in The Annals of Suri^ery, January, 1907]. P>. i^ippincott Company, Publishers, Philadelphia SURGICAL DISEASES OF THE INTESTINES. 729 Success in operations for volvulus, as for other conditions which produceintestinal obstruction, depends to a great degree upon the promptness withwhich they are carried out. The mortality following operation rises very rap-idly in
. American practice of surgery ; a complete system of the science and art of surgery . Sic I ION \ I, \ih:\v Oh ExiicMsivK Gan(;r1:nOus In-iussusci,Iriox, Dih; ro an IXVKRTED MkCKELs DIVERTICULUM I^roni 1 )r. R. C. Coffeys Article in The Annals of Suri^ery, January, 1907]. P>. i^ippincott Company, Publishers, Philadelphia SURGICAL DISEASES OF THE INTESTINES. 729 Success in operations for volvulus, as for other conditions which produceintestinal obstruction, depends to a great degree upon the promptness withwhich they are carried out. The mortality following operation rises very rap-idly in those done after the first forty-eight hours. When a volvulus is exposed an attempt at detorsion should be made. Ifthe bowel is greatly distended, this untwisting may be impossible until after. Fig. 279.—The Drawing Shows the Appearances of the Parts in an Acute Dilatation of the Stomachand Duodenum. The structures exposed to view are the stomach, the lower portion of the duodenum,the mesentery and collapsed jejunum, and the transverse colon, which latter has been lifted into view.(From Dr. Joseph C. Bloodgood, in An7ials of Surgery, November, 1907. J. B. Lippincott Company,Pliiladelpliia, Publishers.) the contents of the loop have first been emptied through an incision. Afterdetorsion, the bowel should be enveloped in a compress wrung out of hot nor-mal salt solution until the question of viability is settled. If this question stillremains in doubt after a reasonable effort in this manner has been made, anenterostomy may be performed or the suspicious loop may be surrounded by 730 AMERICAN PRACTICE OF SURGERY. gauze packing just within the wound, to protect the abdominal cavity in casegangrene occurs. If the bowel is already gangrenous, enterectomy will becalled for, care
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