[Broad resection of the intestine and renal lithiasis].
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On the basis of observations made in 69 patients with traumatic lesions and those caused by foreign bodies in the colon and rectum, supplemented by the data emerging from literature, some clinical and therapeutic considerations are expressed on the subject. A tactic of treatment based on the material examined and, in the present state, advisable as a possible plan of treatment for the said lesions is also proposed.
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Five observations of calculous stenosis of the duodenum after cholecysto-duodenal fistulization are reported. Four times, the pre-operative diagnosis has been made out by an opaque gastro-duodenal transit. The treatment is usually surgical, and its modalities are discussed about, but it is pointed out that the endoscopic duodenal desobstruction on patients running high operative risks presents a real interest.
The usefulness of splinting of the bowel to prevent recurrent bowel obstruction caused by adhesions is analysed. For that is differentiated between three possible indication groups: 1. late bowel obstruction, 2. early postoperative bowel obstruction, 3. mixed peritonitic and mechanical ileus. The risk of splinting of the bowel can only be seen in relation to the number of recurrences, complications and mortality rates as seen in the three indication groups, treated without splinting. From that it shows that in case of peritonitis splinting can only be an adjuvant measure of therapy, and that in case of both recurrent late bowel obstruction and early postoperative bowel obstruction splinting of the bowel has a real preventive effect. This differentiation in indication is of no importance in childhood.
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