. Manual of operative surgery. -enterostomy by forming ananastomosis between the afferent and efferentloops of jejunum at a point 6 inches lowerdown the gut (Fig. 491). Fowler, to makeassurance doubly sure, encircled the afferentloop, between the two points of anastomosis,with a silver wire thread to obliterate itslumen; the same object may be attained by apurse-string suture of silk around the gut atthe same place, Fig. Exclusion.—The above methods endeavoring to obliterate the gutlumen have proven unreliable, at least in the case of the pylorus, as the suturesor ligatures become
. Manual of operative surgery. -enterostomy by forming ananastomosis between the afferent and efferentloops of jejunum at a point 6 inches lowerdown the gut (Fig. 491). Fowler, to makeassurance doubly sure, encircled the afferentloop, between the two points of anastomosis,with a silver wire thread to obliterate itslumen; the same object may be attained by apurse-string suture of silk around the gut atthe same place, Fig. Exclusion.—The above methods endeavoring to obliterate the gutlumen have proven unreliable, at least in the case of the pylorus, as the suturesor ligatures become extruded into the gut which soon assumes its former finds that if the ligature is tied tightly enough to obstruct but nottightly enough to strangulate or cause pressure, then the desired occlusion isattained and maintained. Brewer uses strips of aluminum instead of the same purpose and also to prevent the passage of food into theduodenum after gastro-enterostomy for duodenal ulcer various methods of. Fig. —Rouxs gastro-enteros- {Monod and Vanverts.) PYLORIC EXCLUSION 373 pyloric exclusion have been practised. Operative closure of the stomach orduodenum above the ulcer is not indicated when there is sufficient stenosis dueto the ulceration. Bier writes: pyloric occlusion ought never to be omitted in cases of gastro-jejunostomy when well-marked stenosis is absent and when the operation hasbeen performed for very painful or bleeding ulcers of the pylorus or particularlyof the duodenum. 1. Doyen and v. Eiselsbergs Method.—-Choose a place to the oral side of theulcer and in healthy tissue. Make an opening, close to the lesser curvature,through the lesser omentum and a corresponding opening close to the greatercurvature, through the gastro-colic omentum. Apply two clamps to the stom-ach. Place a strip of gauze behind the clamped portion of the the stomach between the clamps with a thermo-cautery. Close eachstump by a row of thr
Size: 1438px × 1737px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1920, bookpublisherphila, bookyear1921
