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
MACRAE D. MANAGEMENT OF ACUTE CONDITIONS OF THE ABDOMEN: COMPLICATED BY MARKED ILEUS OR SEPTIC INVASION OF THE PERITONEUM. JAMA. 1927;89(14):1113–1118. doi:10.1001/jama.1927.02690140009003
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: