Distention is the symptom that demands immediate attention in late cases of obstruction of the bowels, whether the cause is mechanical, inflammatory or disturbed innervation. The more distended the abdomen is, the more serious the condition. If distention is relieved, the patient is in the safety zone.
The operation for removing the cause may be done later when the patient's condition warrants. This plan of treating obstruction of the bowels by a two stage operation may be likened to the plan of treating prostatic obstruction first by draining the bladder and later by removing the cause.
There are two outstanding reasons for the mortality of obstruction of the bowels: First, the operation is done under ether anesthesia, whether it is a simple enterostomy or an operation to relieve the obstruction, together with an enterostomy. Ether narcosis practically inhibits peristalsis for thirty or forty hours. It is strange that a surgeon
MacKINNON AI. JEJUNOSTOMY, PRIMARY AND COMPLEMENTAL. JAMA. 1928;90(4):257-258. doi:10.1001/jama.1928.02690310009004