Surgery of the ileocecal valve : a method of repairing an incompetent ileocecal valve and a method of constructing an artificial ileocolic valve / by J.H. Kellogg, M.D., LL.D., Battle Creek, Mich.

  • John Harvey Kellogg
Date:
[1913]
Catalogue details

Licence: In copyright

Credit: Surgery of the ileocecal valve : a method of repairing an incompetent ileocecal valve and a method of constructing an artificial ileocolic valve / by J.H. Kellogg, M.D., LL.D., Battle Creek, Mich. Source: Wellcome Collection.

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    gether is secured by abrading the peritoneum or painting it with tincture of iodine. In the great majority of cases this is all that is required to completely restore the competency of the valve. In some cases, however, in which the bowel has been greatly dilated and elongated, both lips of the valve are destroyed and it is then neces¬ sary to suture the opposite side of the junction. Care must of course be taken to avoid narrowing the opening too greatly. The size of the opening may be tested by grasping the valve with the thumb and finger through the walls of the ileum and colon. The competency of the valve may be proved by stripping the ileum toward the colon and then com¬ pressing the ascending colon and making pressure upon the cecum so as to cause reflux if the valve is still incompetent. When the repair of the valve has been properly done, gas and liquid will pass easily from the small intestine into the colon but will not pass backward into the small intestine even when considerable pressure is made upon the cecum. I have performed this operation in thirty cases (June, 1913), with satisfactory results. Examina¬ tion after the operation by Dr. Case, rontgenolo¬ gist of the institution, has shown the repaired valve to be competent in each case. Necessarily, good judgment must be exercised to avoid producing too great narrowing of the valve and obstruction. In all cases in which the opera¬ tion has been done the small intestine appears to perform its function in a perfectly normal manner. It is of course necessary that the patient should, after operation for repair of the ileocecal valve, re¬ ceive such instruction as will enable him to avoid the causes likely to induce a return of the difficulty, as it is conceivably possible that the incompetency may be reproduced, although as yet I have seen no case of relapse. 39
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