Gastric ulcers : their surgical treatment : two papers republished from The Lancet of June 8, 1901, March 29 and April 5, 1902 with an introduction and with brief notes of a case of operation for perforation of an ulcer of the duodenum and of a case of perforation of a cancerous stomach / by C.B. Keetley.

  • Keetley, Charles Bell, 1848-1909.
Date:
1903
Catalogue details

Licence: In copyright

Credit: Gastric ulcers : their surgical treatment : two papers republished from The Lancet of June 8, 1901, March 29 and April 5, 1902 with an introduction and with brief notes of a case of operation for perforation of an ulcer of the duodenum and of a case of perforation of a cancerous stomach / by C.B. Keetley. 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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    TABLE dissecting forceps. The opening thus becomes triangular, and through it the button knob, gripped by the edge with the tip of a pair of catch forceps, should be gently rotated and persuaded to pass in. The forceps which grips the button should then be handed to the assistant, while the surgeon puts in a couple of fine silk sutures through the ‘ sero-muscularis ’ to tighten up. The substitution of these interrupted sutures for a running suture all round the button is, so far as I know, due to Carle and Fantino. Each button should be examined, tested, and found in good order as regards the spring and catches. But for this precaution I should on one occasion have used a defective button. In searching for a retained button with the X rays it is necessary to turn such patients as are not very thin on their faces. The button then falls forward close to the anterior abdominal wall, against which the screen should be placed. A Tabi.e by which this Small Series of 24 Cases may be Analysed into ii Distinct Varieties Variety and _ ' Operated on Recovered No. of case or not or died I Perforation operated 1 Opera- Recovered on as such (Cases i, tion 2, 3, and 4). Ca.se 2 4 also operated on ■' ) 3 recently for adhe- 1 3) 33 1 i 4 sions ” '33 33 1 5 Duodenal perforation. j FiJe supplement 1 3 3 3 3 6 J Gastric perforation. Fide supplement 3 3 3 3 Case l was a ‘ spon- taneous ’ rupture of the stomach. i Each operated on from 24 to 30 hours after the perforation. II. 7, Perforations operated I on as cases of gene- | I ral septic peritonitis: , two cases, each at - 8 ' least four days after 1 perforation (Cases 7 I / and 8) j Died Death partly due to a second perfora- tion after opera- tion on the first. III. 9] Perforations not ope- I rated on (Cases 9 I and 10) I No ope- ) ration »y