New York Lancet Volume 2; With Which Is Incorporated the Archives of Gynecology, Obstetrics, and Pediatrics (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. 1897 Excerpt: ... matter. The abdomen was much distended and there was active peristalsis of the small intestine, with much pain. Examination of the left groin revealed a sloughy cavity from which foul-smelling pus exuded. The patient was taken to the operating theater and anajsthetized, when a large mass of sloughing omentum was found in the cavity together with a small knuckle of intestine. The femoral ring was tightly blocked and nothing could be passed into the lumen of the bowel. The finger was therefore passed up to the ring just against Poupart's ligament and an incision carried upward from the cavity beyond the point of the finger. The incision was now gradually deepened over the point of the finger until Poupart's ligament was completely cut through. The tip of the index-finger could then be gradually passed into the bowel, and no interference whatever was needful with the adhesions at the neck of the sac, but the mass of gangrenous omentum was cut off flush. No immediate escape of fecal matter followed, but a few hours after he had been returned to bed a copious discharge commenced and in twelve hours the abdominal distention had entirely disappeared. There was no further vomiting, and the general condition rapidly improved; in fact there was no further symptom to give cause for any anxiety in the whole history of the case. During the next three weeks the cavity gradually cleaned and contracted, but the whole of his motions passed through it, the character of the discharge indicating that it came from low in the small intestine. On the 28th he passed a normal motion per rectum, and from this date onward the bowels continued to act regularly, while the fistula rapidly contracted so that it would not admit the tip of the finger, the discharge from it steadily decrea...