Collected Papers of the Mayo Clinic Volume 2 (Paperback)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1911 Excerpt: ...every one is agreed that a typical acquired hernia is a rare condition. In a series of nearly 3,000 herniotomies, we have operated upon about 500 patients who were under twenty years of age, and approximately 200 of the number were under five years of age. There has been no mortality following these operations in children and only two relapses. One relapse came in a boy twelve years old, who had a preperitoneal hernia. The protrusion showed as soon as he was allowed to be up, and we believe that it came through a part of the sac that was not properly closed at the first operation. The second relapsing case was a boy nine months old with a very large hernial sac, containing omentum that could not be reduced before operation. A small piece of this had been jammed with a truss, and was removed, the sac ligated high, and the internal oblique muscle and the conjoined tendon sutured to Poupart's ligament anterior to the cord. The relapse came in nine months, and at the second operation we closed by transplanting the cord. Feeling confident that the operation will be attended by unusually good results, with practically no mortality, and that any other method of treatment, such as wearing a truss, does nothing toward an actual obliteration of the vaginal process, and is, therefore, not a true cure, we believe that the operation should be performed at a time most suitable for the patient and for the parents. The indication for performing herniotomy in the child or infant with an easily reducible and painless inguinal hernia is not because of the inconvenience it gives the child, but because of the trouble and anxiety to the child's mother. If away from the child, she worries constantly, fearing that the truss will work loose or the hernia come down; she will feel th...