A case of contusion and rupture of the ileum : with peritonitis, without external wound, successfully treated by coeliotomy and primary enterectomy, followed by circular enterorrhaphy (Maunsell's method) / by Frederick Holme Wiggin.

  • Wiggin, Frederick Holme, 1853-
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: A case of contusion and rupture of the ileum : with peritonitis, without external wound, successfully treated by coeliotomy and primary enterectomy, followed by circular enterorrhaphy (Maunsell's method) / by Frederick Holme Wiggin. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    especially useful when there was troublesome oozing in the abdom- inal or pelvic cavity. Certain experiments which he understood were now being carried 0!i by Professor Thompson, of the University, went to show that peroxide of hydrogen had a special tendency to produce coagulation of the blood, both in the veins and in the arteries. Dr. W. Evelyn Porter said that he was inclined to-belicve that if the dioxide of hydrogen had been used without simple water irrigation it would have caused irritation, and even adhesions. On this account, in advocating its use, it would be wise to recommend in every case that the cavity should subsequently be irrigated with normal salt solution. He believed this should Ije used very generally in abdominal work, not only in acute cases, but in the more chronic ones, especially those found in wofnen. He thought that, in addition to Maunsell’s method, the use of a single row of sutures, either continuous, or Lembert s interrupted sutures, around the outer layer, uniting the peritoneal surhices, would be a verv great safeguanl, as we all knew in any case of intes- tinal suture, uiiless there was very little distension, there was apt to be leakage of the contents of the bowel. He did not like the form of ether inhaler exhibited and recommended by the author. One modified by Dr. Wyeth, with an opening for entrance of air, he con- sidered very much better. Dr. R. A. Murray said he thought that the fatal result in these cases was due most often to delay in operating, and this delay oc- curred usually because the profession at large believed that if there was any septic trouble in the abdomen, there wa.s always high tem- perature, pulse, and respiration. This was a very great mistake. We should call the attention of the profession generally to the fact that more was to be learned from the facial appearance and the con- dition of shock than from the temperature, pulse, and res[uration. For instance, two weeks before he had had a patient with irreducib e crural hernia. Two days before he had seen her this time she ha complained of moderate pain, and as she had been warned about t is pain, she had immediately applied an ice bag, and had sent for him the next day. She had vomited once, but the matter ejected not been greenish; the abdomen had been flat; the pulse had een 72 and the temperature normal. The next day she had vomi ed once- the abdomen had been flat; there had been no impulse in the tumor, although there had been a slight impulse on the previous day • the pulse had been 72, and the temperature had been still