Intestinal obstruction : its varieties with their pathology, diagnosis, and treatment.

  • Treves, Frederick, 1853-1923.
Date:
1904
Catalogue details

Licence: Public Domain Mark

Credit: Intestinal obstruction : its varieties with their pathology, diagnosis, and treatment. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    547/586 (page 533)
    and the occasions in which it is necessary to estabhsh an artificial opening in the gut to be very few. The cases of internal hernia have been already alluded to on pages ]06 and 115. B. Stenosis of the Colon.—The conditions in the colon that, as regards treatment, may be included under this title are:—1. Stricture; 2. Bending of the adherent colon; 3. Compression by adhesions; 4. Obstruction by neoplasms; 5. Compression by a tumour outside the gut; 6. Some enteroliths. Feeding.—In the early stages of stenosis of the colon, the importance of careful feeding is not so emphatically marked as it is in cases of stenosis of the small intestine. Where the colon is concerned, there is at first no immediate connection between the taking of food and the occurrence of pain. Later in the case, anything which excites peristaltic movements is apt to cause pain, and thus the patient feels more uncomfortable after each meal. The pain in stenosis of the colon depends upon the excessive peristaltic movement which attends the attempt to force fsecal matter through the narrowed part of the colon. It will be evident, therefore, that the less bulky the fsecal matter in the gut and the more fluid its consistence, the less distress will be experienced by the patient. As soon, therefore, as a case of stenosis of the colon has advanced to the stage of colic, the feeding of the patient becomes a matter of moment. The diet must be of the most digestiVjle character, and must be of such a kind as to leave the least possible debris in the bowel. If the patient's teeth be imperfect, he should discontinue to eat meat. Milk is seldom tolerated for long by adult patients. It is very apt to lead to scybala. The patient should take his food in small quantities and often. He should take time over his meals and should rest after them. Any existing dyspepsia must be attended to. An attack of obstruction has very often been due to the blocking of the stricture by a mass of undigested food. I remember the case of a patient, who had been long under treatment, and in whom an acute obstruction, demanding immediate operation, was brought about by the eating of some pineapple. When I opened the colon a mass of undigested vegetable fibre was found completely to block the narrow stricture.