On two cases of traumatic rupture of the colon : with some remarks on the cases of rupture of the intestine treated in the wards of St. Thomas's Hospital, London, between the years 1889 and 1898, inclusive / by George Henry Makins.

  • George Makins
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: On two cases of traumatic rupture of the colon : with some remarks on the cases of rupture of the intestine treated in the wards of St. Thomas's Hospital, London, between the years 1889 and 1898, inclusive / by George Henry Makins. 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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    and a gauze plug leading down to the region needed, is the most satisfactory method to employ. After-Treatment.—Shock may need to be met in the same way already indicated in speaking of the primary con- dition, and it is here, perhaps, that saline infusions are most useful: if necessary, a small amount of alcohol may be added to the saline solution. Warm water may be allowed by mouth from the time of complete recovery from the anaesthetic; rectal feeding should be relied on for the first twenty-four hours, after this period (in the absence of vomiting) fluid nourishment may be ad- ministered by the mouth with safety and advantage. Morphine should be avoided if possible. Should distention and sickness herald the advent of sep- tic infection, saline purgation should at once be resorted to as in other cases of peritoneal septicaemia. Sulphate of magne- sia may sometimes be retained, even when vomiting is trou- blesome, by washing out the stomach preliminary to admin- istering each dose. If the suture has been effectively accomplished, I believe there is no fear to be entertained from the administration of a saline purge, while enemata are practically useless in cases of peritoneal septicaemia, and a real danger in cases of injury to the large gut, from the amount of mechanical disturbance of the parts which they produce. ANALYSES OF CASES OF RUPTURE OF THE INTESTINE TREATED IN ST. THOMAS’S HOSPITAL. Table I.—History and Nature of Injury. Case I.—Year, 1889. Reference, J. Croft, Clinical Society’s Trans- actions, Vol. xxiii, p. 141. Male, aged fourteen years. Nature of violence, kick by horse. External signs of violence, none, but history located blow below umbilicus. Part of bowel affected, small intestine, ileum, point undetermined. Nature of injury to bowel, rupture of under surface, three- eighths inch in diameter; corresponding ecchymosed spot on opposite side of gut. Nature of fluid, etc., found in belly at operation, one and a half ounces turbid-brown fluid of faecal odor. Operation, median abdominal section; resection and end-to-end junction. Result, cured.
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