American Practitioner and News Volume 37

American Practitioner and News Volume 37

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This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1904 edition. Excerpt: ...the gastro-jejunic drainage, and by the old methods many of the patients died because of the via'ous circle, and even now where the food begins to pass freely through the pyloric end of the stomach, the opening at the best becomes quite small or occluded, and we may have an impeded peristalsis in the jejunum which may cause trouble., By the most modern methods of making the anastomoses at the bottom of the stomach, either just in front or behind the gastro-colic omentum, we not only get perfect drainage, but usually prevent the vicious circle, and dispense with an anastomosis between the afferent and the efierent limbs of the loop. Some of our best and most successful operators prefer the anterior anastomosis, while others prefer the posterior, and recent statistics seem to indicate a lower mortality in the posterior method. If the operation of Miculicz by which he attempts to eliminate the vzcious circle by anastomosing the stomach to the bowel at three or four inches from its emergence under the meso-colon, and upon a level with this point, meets with a continued success, it may become the operation of election. In the posterior anastomosis, both the Murphy button and the sutures have been used, but the operation can probably be performed more easily by the button. The stomach is brought through an opening in the meso-colon, but we must be careful to cut as little as possible, and avoid the arteries in the mesentery, and especially the middle colic artery, for its division would probably cause fatal gangrene. In the anterior anastomosis Murphy uses the button, but the majority of operators dispense with it, and unite the bowel to the stomach by the suture, after one of several methods that have been practiced. The simplest and more

Product details

  • Paperback | 150 pages
  • 189 x 246 x 8mm | 281g
  • United States
  • English
  • black & white illustrations
  • 1236923294
  • 9781236923295