Atonic dilatation of stomach : gastrorrhaphy / by F.C. Shattuck, C.B. Porter and James H. Wright.

  • Shattuck, Frederick Cheever, 1847-1929.
Date:
[1897]
Catalogue details

Licence: Public Domain Mark

Credit: Atonic dilatation of stomach : gastrorrhaphy / by F.C. Shattuck, C.B. Porter and James H. Wright. 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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    cision, changed, the cardiac end of the stomach pulled down as much as possible, and one or two Lembert sutures placed in such a way that when drawn tight a part of the wall would be folded in. This was accomplished by making the space between the places where the suture passed into the wall of the stomach as wide as possible. Few similar sutures then placed about the middle of the greater curvature. The pyloric end of the stomach was then pulled up as far as possible and similar sutures passed. These were to be used as guides, and were so placed that when tied they would bring the line of the greater curva- ture as high up toward the lesser curvature as possible—perhaps one and one-half to two inches below. These guide-sutures were then tied, and the fold thus made was held invaginated while its edges were caught all the way along by a row of interrupted Lembert sutures. Holding the stomach during the last part of the operation was ex- tremely difficult, as its muscular contraction seemed to have been excited by the manipulations. After the suturing stomach was allowed to retract into the abdominal cavity. No bleeding. Incision closed by double headers of silk through peritoneum, muscle, and fascia, and by a continuous silk stitch in the skin. Dressing, swathe. In good condition. Incision below ribs. Pylorus explored by finger through incision in anterior wall of stomach. • No stricture. Anterior wall invaginated and sutured. Gastrorrhaphy. Abdominal wall sutured in two layers. As soon as in bed, enema. Coffee, brandy aa §ij ; salt ad. one pint. During afternoon, subcut. strychnia, gr. Visited by Dr. Porter in late afternoon, who ordered morphia, gr. ^ by subcut. Patient to have absolutely nothing by mouth. Enema every six hours. Beef juice, peptonized milk §j, egg albumin gj, whiskey, and salt sol. aa §ss. Suds and glycerine enema every morning to clean out rectum. 19M. Urine: first after ether, albumin, none; sugar, none ; 1025; acid; slight increase in color. Morphia gr. subcut. last night. Patient fairly comfortable. Whiskey omitted from enemata, as pulse good. Chloral gr. xv, bromide gr. xx in night enema. 2oi/i. Complains of feeling nervous, otherwise doing nicely. Has had no vomiting since operation, not even during recovery from ether. Spits up a little today. Morphia gr. subcut. and bromide gr. XXX at 9 p. M. Enema. Seen in the evening. As patient seems to have lost ground a little, decided to start with mouth-feeding. (Food by mouth second day after operation.) .^ss doses every half hour of either albumin-water, beef-juice, whiskey, soda-water, black coffee.