Ileal stasis / by Lewis Gregory Cole, M.D. New York.

  • Cole, Lewis Gregory, 1874-1954
Date:
[1914?]
Catalogue details

Licence: In copyright

Credit: Ileal stasis / by Lewis Gregory Cole, M.D. New York. Source: Wellcome Collection.

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    is atony and dilatation, some surgeons attempt to reduce the size of the colon and hold it in position by artificially producing the conditions which the aformentioned group of surgeons try to de¬ stroy. The most successful method of surgical treatment for such cases could be determined by post-operative roentgenologic in¬ vestigations in conjunction with careful clinical observations. Kinks in the terminal portion of the ileum, either with or without mobile caecum, undoubtedly do occur and cause the group of symptoms described by Lane and recognized by others. On several occasions I have been able to recognize them with an ac¬ companying dilatation of the proximal ileum, and I have been able to demonstrate them to the most sceptical observer. But these kinks are a rare rather than frequent cause of ileal stasis. Where a kink really exists and causes ileal stasis and dilatation, especially if it is associated with symptoms, surgery for its relief is undoubtedly indicated. But operative procedure intended for the relief of such kinks will not cure all cases of ileal stasis, nor relieve the accompanying symptoms. Furthermore if the stasis is not caused by a kink, operative procedure may aggravate the symptom. Insufficiency of the ileo-csecal valve is a condition which I first recognized in 1902. Out of the cases examined since that time, I have observed about two hundred and fifty cases of this irregularity, and have used every effort to arouse the interest of surgeons and practitioners in the subject without success. Even now in cases where the clysma passes all the way to the duodenum, and the patients present marked abdominal symptoms, surgeons and practitioners refuse to attribute any significance to this finding. I find that the only way I can interest them is to ask if they would expect symptoms, if they fed their patients faeces removed from the colon. I have failed to report this group of cases, at first because the question of tuberculosis occupied my attention and later because my efforts were concentrated on gastro-duodenal lesions. Kraus, Schwartz, Holzknecht, and more recently Groedel and Dietlan, have reported roentgenographic observations of ileo-caecal insufficiency. Case has published an article, and on several occasions demonstrated slides, showing the frequency with which this lesion manifests itself. Its clinical aspects have been described by Kellogg, who has recently devised an operation for repairing an incompetent valve, and a method of constructing an artificial one, which will undoubtedly create a great interest in the whole subject.