Image from page 628 of “American practice of surgery ; a complete system of the science and art of surgery” (1906)

Image from page 628 of “American practice of surgery ; a complete system of the science and art of surgery” (1906)
Healing Arts
Identifier: americanpractic07brya
Title: American practice of surgery ; a complete system of the science and art of surgery
Year: 1906 (1900s)
Authors: Bryant, Joseph D. (Joseph Decatur), 1845-1914, ed Buck, Albert H. (Albert Henry), 1842-1922
Subjects: Surgery
Publisher: New York, W. Wood and company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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of laparotomy wounds at the middle line, in the region of theappendix, in the epigastric and gall-tract regions, and in the lumbar region, atthe site of the incision made for a kidney operation. They also may appear atthe site of any wound or laceration due to an injury (jr a stab or bullet wound. In the Mercy Hospital Clinic I recently had under my care a patient who, inconsequence of a crushing injury of the chest and abdomen, had experienced afalse hernia of the colon and part of the liver, complicating a hernia of the lung.Recovery took place in due time. and. after the final healing, a true ventral herniapersisted in the right hypochondrium. Treatment.—Palliation l-)y bandages, belts, and spring trusses may pre-vent increase in the size of the protrusion. In many cases the prophylacticuse of such supports fails to prevent hernia from appearing. Ijut it may restrainthe tumor from assuming large proportions. Operations upon ventral hernia vary with the locality, the degree of the

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^^^S**. – § Fig. 243.—Diagram Showing a Congenital Hernia of tlie Xavel and Corel. The sac contains bothhollow and soUd ^•isce^a. (From Wilms.) U, UmbiUcal cord; /, intestine; L, liver; L T, round ligament; V, stomach; C, colon; R, ring. defomiity, and the amount of destruction of tissue which has taken place aboutthe false opening. In many cases dangerous adhesions exist between the is-cera and the interior of the sac. In other cases destructive cutting of musclesor their motor nerves has caused large breaches in the smooth contour of theabdominal wall which can never be restored by merely suturing the lavers. Insuch cases it may be better to resort to flap methods, as by imbrication of rec-tangular flaps of the rectus sheath, and to make an anatomical dissection ha^dngfor its purpose to free the various planes of fascia, in order that afterward theymay be restored to their normal relations. The treatment of epigastric hernia should be by operation. The small sac 602 AMERICAN P

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