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Article
October 1952

PLICATION OF SMALL INTESTINE FOR OBSTRUCTION DUE TO ADHESIONS—NOBLE PROCEDURE

Author Affiliations

CLEVELAND
From the Department of Surgery, Western Reserve University School of Medicine, and University Hospitals.

AMA Arch Surg. 1952;65(4):487-498. doi:10.1001/archsurg.1952.01260020503001
Abstract

OBSTRUCTION of the small intestine due to adhesions is difficult to cure permanently. This is especially true when the patient has had previous laparotomies for the same condition. Gentle handling of tissue, avoiding infection, irritating glove powder, and other foreign bodies, will not prevent the re-formation of adhesions from raw surface areas residual at the time of surgery. For this reason, relief of obstruction by lysis of adhesions is frequently temporary.

The many attempts to prevent peritoneal adhesions have been well outlined by Boys1 and more recently by Schiff, Goldberg, and Necheles.2 The experimental attempts to control the formation of adhesions by preventing the deposition of fibrin by anticoagulants, and more recently the use of cortisone, as reported by Scheinberg and Saltzstein,3 are of much interest. However, the experience of Hubay, Weckesser, and Holden,4 using cortisone in dogs, casts doubt on its practical value at present.

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