Laparotomy for apparent intestinal paralysis which caused arrest of the intestinal contents and was equivalent to intestinal obstruction / by W.W. Keen.

  • Keen, William W. (William Williams), 1837-1932.
Date:
[1893]
Catalogue details

Licence: Public Domain Mark

Credit: Laparotomy for apparent intestinal paralysis which caused arrest of the intestinal contents and was equivalent to intestinal obstruction / by W.W. Keen. 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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    of fcEeal matter in the bowel and absorption of the ptomaines of decomposi- tion will always be doubtful, but it seems reasonable to suppose, that this was the cause of the mental and to a large extrntof the physical condition. The evidence of this rests on the horribly fetid discharges which took place soon after the operation, with the simultaneous»clearing of a very foul tongue, the disappearance of a very fetid breath, and the betterment of her mental condition. Secondly : The lapartDtomy was entirely exploratory and the case shows the wisdom of it. The laparotomy was done to make a diagnosis as well as to institute such treatment as the conditions found would warrant. The case shows also the wisdom of small incisions in the bowel,incisions which can be perfectly well made and closed by any of the ordinary intestinal sutures, rather than making punctures and leaving them to heal without sutures. The distended large bowel was relieved of its tension and resum- ed its function, whether by the stimulus of the handling and washing out of the belly-cavity with hot water or the re-establishment of the peristalsis of the small intestines I cannot say. Probably each one of these factors had some influence in bringing about these results. In closing the intestinal incision I used Cushing's continuous right- angled suture as shown by him in the Boston City Hospital Keports for 1889. I think it very easy of application and very speedy and satisfactory. I did not use the rather complicated method he described of securing the two ends. The first end I simply tied in an ordinary knot and the last end I slipped through its own loop two or three times and cut it off short.