Transactions of the Western Surgical Association Volume 24

Transactions of the Western Surgical Association Volume 24

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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. 1915 edition. Excerpt: the center but to one side. On the other hand, if the handkerchief is so held that the opening is smaller than the diameter of the tube no spur will form. This experiment is easily tried and is convincing. The explanation is that the laws of dynamics determine that the larger viscus expands at the expense of the smaller one, thus causing the farther wall of the smaller one to rise into the opening when the latter exceeds a certain size. A spur of this kind if larger or if to one side may easily obstruct the outward passage of the gastric contents. This explanation accounts, I am convinced, in some cases, for defective drainage after gastro-enterostomies, and would also account for defective drainage in making a lateral anastomosis of the small intestine to the large intestine. This is not altogether theoretical nor altogether confined to my handkerchief. A day or two ago I operated upon a case in which there was defective drainage of the stomach following a gastro-enterostomy done elsewhere. After opening the abdomen and examining the stomach, I found the gastro-enterostomy opening at least three inches long. Upon distending the opening a spur rose up in the center in a very striking manner. I attempted to correct this by making a second gastro-enterostomy opening, and it has not been sufliciently long for me to state whether this has relieved the difficulty or not, but it was nevertheless quite apparent to me what the difficulty was. Another thing that we have to bear in mind is that in uniting the large bowel, one portion to another, we must take into consideration the mesenteric pull which may take place upon these separate parts relative to each other. For instance, if we make a lateral anastomosis of the cecum to the sigmoid, more

Product details

  • Paperback | 104 pages
  • 189 x 246 x 6mm | 200g
  • United States
  • English
  • black & white illustrations
  • 1236903633
  • 9781236903631