Transactions of the Southern Surgical and Gynecological Association . ns is a life-saving process. Take for example a case ofperforative appendicitis. The appendix is inflamed, ulcerationbegins from the inner side of the appendix; long before theperforation has reached the cavity of the peritoneum the peri-toneum throws out plastic material forming limiting adhesions,restraining and circumscribing the infectious matter, which ispoifred out through the perforation. The same is true ofsalpingitis. As soon as the tube is infected the peritoneal S Surg 19 290 PLASTIC WORK IN ABDOMINAL SURGERY. coa
Transactions of the Southern Surgical and Gynecological Association . ns is a life-saving process. Take for example a case ofperforative appendicitis. The appendix is inflamed, ulcerationbegins from the inner side of the appendix; long before theperforation has reached the cavity of the peritoneum the peri-toneum throws out plastic material forming limiting adhesions,restraining and circumscribing the infectious matter, which ispoifred out through the perforation. The same is true ofsalpingitis. As soon as the tube is infected the peritoneal S Surg 19 290 PLASTIC WORK IN ABDOMINAL SURGERY. coat of the fimbriated end begins to swell and soon closes theextremity of the tube, thus sealing the tube and preventingthe infectious matter from reaching the peritoneum by thischannel. So then this plastic exudation should not be consideredpathological, even though we grant that it never occurs in astate of health, but only when some morbid process is abdominal surgeon should ever bear this valuable and tome wonderful property of the peritoneum in But often this very conservative effort of Xature is per-verted into a pathological condition, such for instance are theadhesions forming after abdominal section. These adhesionsare hurtful in that they may produce (1) painful peristalsis;(2) constant pain; or even (3) ileus. So common is it foradhesions to form after an abdominal section that the Amer-ican Text-booh of Gynecology says they always occur. The occurrence of adhesions was forcibly impressed on mymind in the case of a negro woman from whom I removed anintraligamentous growth. After hulling out the tumor, thebed seemed clean and free from hemorrhage, and I did not J. W. LONG. 291 regard it necessary to close the parts. Four days after theoperation I was compelled to reopen the abdomen, because ofa leaking intestinal wound, when I found that coils of smallintestine had fallen down into the cavity from which I hadremoved the tumor, and were densely adheren
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