. Diseases of the rectum and anus: designed for students and practitioners of medicine. f bowel to be removed varies in different cases,depending upon the presence of adhesions and more especiallyupon the length of the mesentery. The position of the perito- COLOSTOMY 603 neum and length of the mesentery differ materially in a largeseries of cases. Mr. Herbert W. Allingham has made an ex-haustive study of the mesenteric attachments of the colon andsigmoid, and has fully pointed out the necessity of properlyhandling the mesentery in colostomy operations of every de-scription in order that a succ
. Diseases of the rectum and anus: designed for students and practitioners of medicine. f bowel to be removed varies in different cases,depending upon the presence of adhesions and more especiallyupon the length of the mesentery. The position of the perito- COLOSTOMY 603 neum and length of the mesentery differ materially in a largeseries of cases. Mr. Herbert W. Allingham has made an ex-haustive study of the mesenteric attachments of the colon andsigmoid, and has fully pointed out the necessity of properlyhandling the mesentery in colostomy operations of every de-scription in order that a successful artificial anus may be estab-lished and a prolapse of the bowel through the opening avoidedin after-years. He divides mesenteries into the short, whenthere is practically none; the medium, where it is from two tothree inches ( to centimeters) in length; and long,when it reaches five inches ( centimeters) or more in length(Figs. 186, 187, and 188). In performing left inguinal colostomy the author followsAllinghams plan of making the gut taut by drawing it out from. Fig. 192.—Mesentery made Taut. above and from below before it is sutured to the skin ( and 192). Sometimes only a small loop of the intestine isanchored and later cut away; in other cases in which the mesen-tery is quite long, from three to twelve inches ( to ) of the bowel is amputated in order to provideagainst a future procidentia. Owing to adhesions or the ab-sence of a mesentery, it is sometimes impossible to do morethan bring the upper surface of the bowel up sufficiently tounite it to the skin. This is a very unfortunate condition, forthe reason that it is impossible in such cases to make a properspur and thus prevent all of the feces from passing over thediseased bowel below the opening. AVhenever possible, theentire circumference of the bowel should be brought above thelevel of the skin (Figs. 189 and 192); so that when it is exciseda bridge of intestine will
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanusdis, bookyear1910
