Reports of Societies

1911 Boston Medical and Surgical Journal  
are in accord with the generally accepted ideas of surgical treatment. The demonstration of the rapidity of absorption, after interference with the circulation, emphasizes the necessity of early operation and restoration of the circulation, as well as removal of the obstruction. The observation that the toxic intestinal content is not absorbed to any degree through the normal mucous membrane may influence materially the . surgical treatment, because if this is so, an enterostomy for permanent
more » ... omy for permanent drainage is futile, since if there is strong peristalsis to make the enterostomy effective, it would, after the obstruction is removed, force the content beyond the zone of possible absorption. In the cases in which peristalsis is evidently going to be lacking or obstructed on account of the damage to the wall of the intestine, our findings would indicate a resection of the segment involved, rather than any of the various procedures such as irrigation or massage, because of the danger from the presence of intestine, which may act as a reservoir for the formation of the toxic substance, as well as furnish an avenue of absorption. The relatively low toxicity of the free fluid in the abdominal cavity, except in the terminal stages of the obstruction, would suggest that drainage of the peritoneum was indicated only when demanded by some local septic process.
doi:10.1056/nejm191111021651803 fatcat:eaqncsqtyvch5h2m6ozzxl6w7q