Diseases of the colon and their surgical treatmentW. Wood, 1910 - 322 lappuses |
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abdomen abdominal wall abscess acute obstruction adhesions anastomosis angle aperients appearance appendices epiploicæ appendicostomy appendix artery artificial anus ascending colon attacks become blood blood-supply bowel lumen bowel wall bowel-wall cæcal cæcum cæcum and ascending cancer cause chronic colitis chronic constipation close colotomy condition considerable constipation diagnosis diarrhoea dilated disease distention diverticula examination excision fæcal fistula fæcal material fæces fistula glands growth hæmorrhage hernia ileum iliac fossa inches incision inflammation injected instances intestinal obstruction intussusception kink later layer lesion loop massage mesentery mesocolon mesosigmoid method mucosa mucous membrane mucus muscular coat normal occur operation passed patient pelvic colon performed pericolitis peristalsis peritoneal cavity peritoneum polypi portion of bowel possible post mortem present rectum removed resection result secondary seen sigmoid flexure sigmoidoscope skin small bowel splenic stitched stools stricture sutures symptoms thickening tissue transverse colon treatment tube tubercle tuberculosis tumour twist ulcerative colitis usually volvulus
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255. lappuse - They increase slowly, and but seldom, and only in their later stages, give rise to metastatic deposits in other parts of the body. They do not readily become adherent to important organs, though an exception to this statement must be made in the case of growths of the transverse colon, which frequently involve the stomach. Large portions of the colon can be removed without causing the patient any serious subsequent inconvenience or preventing him from enjoying life. The most important factor, as...
281. lappuse - ... possible to perform colotomy, or when a colotomy opening will not be above the seat of obstruction. It is also sometimes done to deflect the faecal current from the colon in cases of ulcerative colitis. The caecum is exposed through an oblique incision, the centre of which lies over a point halfway between the umbilicus and the right anterior superior spine of the ileum. The anterior wall of the caecum is drawn out of the wound, and a small circular area of the csecal wall about ^ inch in diameter...
286. lappuse - The operation is performed as follows : An oblique incision is made over McBurney's point in the same way as in the ordinary operation for appendicectomy. The incision need only be a short one, and 1J inches is often sufficient. The " gridiron " incision is an excellent one, the muscles being split in their length instead of being divided. The peritoneal cavity is opened and the appendix found. The mesoappendix is then, if necessary...
277. lappuse - ... these methods of valvular colotomy is that they give no better control than the operation already described, as the opening tends after a short time to straighten out and the valvular arrangement is obliterated. Also, they result in the opening being very inconveniently placed. Lumbar Colotomy. — The patient is laid upon his side with a firm cushion or sand-bag under the loin, in order to flex the trunk sideways and open out the space between the last rib and the iliac crest. The position of...
83. lappuse - ... angle, it is more than likely to fail when the sigmoid flexure is involved, owing to the weight of this part of the colon when filled with solid faeces, causing the adhesions to tear away. Operation for Shortening the Mesocolon. — The loop of bowel forming the volvulus is drawn out of the abdominal wound and held towards the inner side of the wound by an assistant, so that the mesocolon is put slightly on the stretch. A row of Lembert sutures is then inserted, taking up the peritoneum only,...
95. lappuse - ... with electrical treatment to stimulate the movements of the bowel. The electrical application should be given first, and should be followed by massage. After the first week, exercises against resistance should follow the massage. These exercises should be those which contract the abdominal muscles and which flex the spine and thigh. Such exercises do good by moving the parietal peritoneum through the agency of the muscles in contact with it. Treatment should be continuous at first, and the shortest...
101. lappuse - This sponsorship has been one of the most important factors, if not the most important, in the development of the present air transport system.
281. lappuse - ... wall about ^ inch in diameter is enclosed in a pursestring suture. This portion of the caecal wall is then held up by an assistant, and a small incision into the caecum is made in the centre of the circular area ; through this one end of a Paul's tube is pushed, and the purse-string suture is then tied firmly on to the tube. The caecal wall is stitched into the wound and the latter closed, leaving the Paul's tube projecting. Owing to the liquid nature of the contents of the caecum, the control...
69. lappuse - ... short-circuiting operation is preferable. In one case I performed appendicostomy for this condition. The operation was done in the hope of being able to prevent accumulation in the distended sigmoid by washing out the whole colon daily with water through the appendix. The patient, a man aged twenty-two, was quite well between the attacks of obstruction from which he suffered, and it did not seem justifiable to subject him to the danger of excision of the enormous loop of dilated bowel, unless...
240. lappuse - ... Cfficostomy has been performed. This was done in Lienthall's case, and the patient's symptoms were somewhat alleviated ; but no diminution in the size or number of the polypi resulted. Colotomy does not relieve the symptoms and only adds to the patient's distress. The disease is a very serious one and there is every probability that cancer will develop, if it has not already done so. Under these circumstances any operation would seem justifiable that affords a possibility of removing the disease....