. Manual of operative surgery. on of the psoas parvus muscle, or if this is absent, the internal borderof the psoas, in which case it is necessary to retract the artery inwards to per-mit suturing. Introduce three or four non-absorbable sutures through thetendon of the psoas parvus and then through the posterior longitudinal caeco-colic band. When these sutures are tied the caecum is well anchored in the 438 OPERATIONS ON THE INTESTINES iliac fossa. Suture the edges of the incision in the iliac peritoneum to the headof the caecum. Caecopexy plus Caecoplication.—Roeder (Journ. A. M. A., Feb. 25
. Manual of operative surgery. on of the psoas parvus muscle, or if this is absent, the internal borderof the psoas, in which case it is necessary to retract the artery inwards to per-mit suturing. Introduce three or four non-absorbable sutures through thetendon of the psoas parvus and then through the posterior longitudinal caeco-colic band. When these sutures are tied the caecum is well anchored in the 438 OPERATIONS ON THE INTESTINES iliac fossa. Suture the edges of the incision in the iliac peritoneum to the headof the caecum. Caecopexy plus Caecoplication.—Roeder (Journ. A. M. A., Feb. 25, 1911)introduces a number of sutures (hemp or silk) into the outer side of the caecumin the manner shown in Fig. 597. The last bite of the stitch is in the parietalperitoneum just external to the root of the meso-ca?cum. The number of biteseach stitch takes in the gut is regulated by the amount of dilatation number of stitches used is of course in proportion to the length of intestineto be plicated and I iG. 597.—[Roeder.) DIVERTICULITIS The papers of Cahier (Rev. de Chir., September 19, 1906), Brewer(Amer. Journ. Med. Sc, October, 1907), Mayo (Surg.,Gyn. and Obstetrics,July, 1907) and others have attracted attention to a condition named acquireddiverticulitis. A few words explanatory of the disease may assist the or false diverticula are simple hernia? of the mucous and submucoustunics through the circular muscular coat of the descending colon and sigmoidat points where the musculosa happens to be weak. Chronic leakage may takeplace through the diverticular walls and give rise to large inflammatory de-posits. The result of the inflammation may be: (i) Abscess. This requiresfree drainage. (2) Acute local infection plus acute obstruction. This re-quires free drainage plus the establishment of an artificial anus. Subsequently,if necessary, the diseased segment of colon may be excised. (3) Chronic ob-struction with inflammatory tumor b
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