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Article
October 1, 1927

MANAGEMENT OF ACUTE CONDITIONS OF THE ABDOMEN: COMPLICATED BY MARKED ILEUS OR SEPTIC INVASION OF THE PERITONEUM

Author Affiliations

COUNCIL BLUFFS, IOWA

JAMA. 1927;89(14):1113-1118. doi:10.1001/jama.1927.02690140009003
Abstract

Having performed thousands of laparotomies during the last thirty-five years, and having attempted the various technics advocated from time to time during this period, I have now practically discarded drainage of the general peritoneal cavity, but have established, almost as a routine, draining of the intestine in all doubtful cases. As a consequence my mortality in the desperate type has been reduced at least 50 per cent.

Drainage of walled off pus collections or extraperitoneal cellulitis, or the insertion of foreign material into the gangrenous or suspicious locations in order to render the part extraperitoneal (quarantine), must not be confused with the contamination of the peritoneum itself, which does not require drainage, for the very good reason that such drainage is impossible.

Although no claim is made for originality in the technic of jejunostomy, I believe that the extended use of the tube advocated in this paper to include all

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