. A manual of gynæcology and pelvic surgery, for students and practitioners. Fig. 251.—Appendectomy. The appendix buried. The entire appendix isbrought out minus its peritoneal coat. collapse of a large abscess cavity, when the patient is anaesthe-tized and the muscles relaxed, might allow pus to escape into thegeneral peritoneal cavity. The mass should be broken into with the finger, which seeksout the lines of least resistance between the coils of adherent APPENDECTOMY 549 gut, and it often happens that the appendix can be quickly out-lined, especially in cases which have lasted but three or
. A manual of gynæcology and pelvic surgery, for students and practitioners. Fig. 251.—Appendectomy. The appendix buried. The entire appendix isbrought out minus its peritoneal coat. collapse of a large abscess cavity, when the patient is anaesthe-tized and the muscles relaxed, might allow pus to escape into thegeneral peritoneal cavity. The mass should be broken into with the finger, which seeksout the lines of least resistance between the coils of adherent APPENDECTOMY 549 gut, and it often happens that the appendix can be quickly out-lined, especially in cases which have lasted but three or fourdays. If it cannot thus be found, the anterior cecal band shouldbe traced to its base, and adhesions gently pushed away as thefinger outlines the appendix, until it can be demonstrated as. 252.—Appendectomy. Clamping the mesentery. before. In an old abscess case in which the appendix forms anintegral part of the median wall, and in old retro-cecal abscesseswhich are best opened extraperitoneally, it may be injudiciousto seek the appendix at all, both because the peritoneal ca^^tywill be badly contaminated and because absorption from these 550 DISEASES ASSOCIATED WITH GYNECOLOGIC LESIONS surfaces is extremely rapid, but these cases seem to grow morerare as ones experience increases. Ligation of the Mesentery and Treatment of the Stump.—Themesentery should be ligated in one or more sections, dependingupon its length and thickness. Clamping may precede the
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