Transcription

            Intusseption

Operation not indicated until

evidence of obstruction

[sketch]   Peritoneum

               Gut may slough at 1, when

               have natural cure

               Cut into bowel at 2.

               Amputate intussepted at 1

part & close 2. with over & over

& Leuchert

      Obstruction [symbol with] Ileus

Pick up first loop of bowel

come to 8 with purse string

sut use Pauls Tube or heavy

tubing milking gut in

tube to relieve gas etc.

When find gangrenous gut in

Hernia generally have Ileus

so safer to do euterstomy so as

to drain source of infection

Xcise gangrenous portion & sut.

ends to Parietal Peritoneum &

over & over sut - put tube

drain in each end of gut

coming out thru ring

In Obstruc. where pt. in xtremis

pick up first loop of gut, put

tube in each end & sut. to

parietal peritoneum, which acts

as drainage - obstruc to be

relieved later if this helps

out pat.

                   Colostomy

McBurney incision on

left side - loop pulled

up thru incis. - parietal &

visc. peritoneum sutured.

Tube under loop till peritone

united & gut ready to open

This for temporary or perma-

nent where drainage desired.

Gut opened [symbol with] cautery or knife