StThomas's Hospital reports . pty and the absence of Dr. Sharkey, the patient was seen byDr. Hawkins, who considered an operation afterwards chloroform was given and a median inci-sion made below the umbilicus. The abdominal walls con-tained a thick layer of fat. The large intestine was foundcollapsed from the sigmoid to the csecum. The coils of smallintestine on the surface were moderately distended, but ondisplacing these to the left side, a bunch of collapsed bowelwas found in the right iliac region, and on gently bringingthis to the surface, a portion slipped
StThomas's Hospital reports . pty and the absence of Dr. Sharkey, the patient was seen byDr. Hawkins, who considered an operation afterwards chloroform was given and a median inci-sion made below the umbilicus. The abdominal walls con-tained a thick layer of fat. The large intestine was foundcollapsed from the sigmoid to the csecum. The coils of smallintestine on the surface were moderately distended, but ondisplacing these to the left side, a bunch of collapsed bowelwas found in the right iliac region, and on gently bringingthis to the surface, a portion slipped out of a hole in themesentery. On examining the collapsed intestine, whichwas about the size of the little finger, four constrictionswere found in it, two close together near the csecum, andtwo others also close together and about five feet from thefirst pair. The coats of the bowel were intact, and theconstrictions had evidently not been very tight. Here andthere on the collapsed bowel were patches of adherentlymph. Fig. The mesentery presented a circular hole (Fig. 2) withclean cut edges about f of an inch in diameter, situated aboutmidway between its root and intestinal margin, and about 174 Eight Cases of Abdominal Surgery. 3 inches from the csecum. A small calcareous nodule wassituated in the mesentery close to the edge of the perforation,and a second one, the size of a split-pea, some inch nearerthe intestine. The mesentery appeared well supplied withblood-vessels, one running within i of an inch from themargin of the aperture. A circular incision was made inthe mesentery surrounding the perforation about \ of aninch from its edge, a ring of mesentery being thus excised. In doing this five small arteries had to be edges of this now enlarged hole were sutured by acontinuous Lemberts suture of silk uniting the peritoneumon each surface of the mesentery. The abdominal woundwas now closed by three sets of sutures, continuous catgutin the peritoneum, silk Le
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