Boston Society for Medical Improvement

1897 Boston Medical and Surgical Journal  
after a reasonable trial of the usual non-operative procedures ; for example, gastric lavage, rectal injections of gas or water in the knee-chest position, massage, or gentle manipulation with full narcosis. A cure by spontaneous disinvaginatiou or sloughing of the invaginated segment is no more to be expected than in a strangulated hernia. Rydygier operates after two unsuccessful attempts at reduction by rectal injections of water, in acute cases, as soon as possible. After laparotomy has been
more » ... laparotomy has been done, disinvaginatiou is to be attempted if it can be done without especial difficulty. If the vitality of the intestinal wall is doubtful, especially at the poiut of constriction, the affected point is packed off by iodoform gauze from the general peritoneum and the abdomen left unclosed. Of 24 cases where reduction was possible and the intestine disinvagiuated, eight recovered. When disinvaginatiou cannot be done, the intussusception should be resected; and the operation is described. The entire mass is to be resected, however, when the invaginatiug sheath shows changes indicating impaired vitality and perforation.
doi:10.1056/nejm189708191370808 fatcat:j24j45xaw5f4nmnoq2argajfba