Diseases of the stomach and their surgical treatment / by A.W. Mayo Robson and B.G.A. Moynihan.
- Robson, A. W. Mayo (Arthur William Mayo), 1853-1933.
- Date:
- 1901
Licence: Public Domain Mark
Credit: Diseases of the stomach and their surgical treatment / by A.W. Mayo Robson and B.G.A. Moynihan. 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.
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![men and women, formerly invalided by pain and dyspepsia, are now leading active and useful lives. Slight adhesions we are accustomed to separate with the fingers, firmer bands to divide between ligatures, going carefully to work until the pylorus is quite free. Where the omentum is available, we usually bring the right border upwards, and leave it between the pylorus and the gall-bladder and the liver, so that, should any adhesions form again, they will be in the form of a loose mesentery, and not binding, like adhesions to fixed organs. The operation of gastrolysis, where adhesions are solely responsible for the stomach trouble, is a perfectly safe one, and in a large series of operations we have had no fatality. In the Hunterian Lectures we collected from all sources ]] operations, the rate of mortality being 2*5 per cent. Of these, 47 were personal cases without a death. Wherever the adhesions are very firm, and especially where they are extending over a wide area, great care must be exercised in separating them, and when separated, in examining the stomach carefully to see if there is a fistula left, for in no less than seven cases we have had to close perforations under such circumstances ; and, in several of them there was a clear history of perforation of gastric ulcer, with subsequent recovery, though the symptoms of ulceration had persisted and necessitated operative treatment. A case of stomach and gall-bladder fistula (seen by Mayo Robson) in a lady of fifty-four, due to perigastritis of extrinsic origin, is described in the chapter on Fistula. When the adhesions were separated there was a passage into the stomach readily admitting a No. 6 catheter, which was easily closed by a purse-string suture, the gall-bladder open- ing being used for drainage, the patient making a good recovery. In another case, that of a middle-aged lady, seen by Mayo Robson, with Dr. Johnstone of Ilkley, on separating the pylorus from the liver, an opening was found the size of a threepenny-piece leading into the stomach, the base of the ulcer being formed by indurated liver tissue. The case is more fully described under Pyloroplasty. 15—2](https://iiif.wellcomecollection.org/image/b21209236_0243.jp2/full/800%2C/0/default.jpg)
