For a long time surgeons have held that abscesses should be drained at their most dependent portion. The principle is so firmly established—in fact, so self-evident—that one wonders that it should ever be necessary to enunciate it. But it is, as anyone who teaches clinical surgery will vouch. When, however, one suggests that this principle should be applied in attempted drainage of the abdomen a storm of protest arises, the chief objection with which I have had to contend being that the abdominal cavity cannot be compared with abscess cavities, for here we have "the intra-abdominal pressure" favoring our attempts to drain; just as if the walls of any ordinary abscess exerted no pressure whatever!
It is granted that intra-abdominal pressure favors drainage of the abdomen, let the opening be where it will, but surely that pressure can work to better advantage if it does not have to
COUGHLIN W. POSITION AS A FACTOR IN DRAINAGE OF THE PERITONEAL CAVITY. JAMA. 1912;LVIII(10):679–681. doi:10.1001/jama.1912.04260030079002
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