On acute intestinal obstruction

Conclusions

Should there be difficulty in finding the site of the obstruction:-

• (a) Follow engorged coil of intestines upwards and down wards until point of obstruction is reached or turn out all the intestines.

• (b) Remove all fluid from Douglas’ pouch and loins by irrigation with sterile water.

• (c) Eestore colour of bowel, and establish peristaltic movements by heating with neutral saline solution. The removal of the primary cause of intestinal obstruction is not always followed by relief of the symptoms.

• (d) Should there be difficulty in returning intestines, elevate pelvis in Trendelenburg’s position, or, if necessary, open and wash out.

• (e) Before all, and above all these conclusions, I would lay down this rule, or formulate this axiom:-“When a surgeon is called to a case of complete obstruction of the bowel, with evidence of peritoneal effusion, it is his duty to operate at once.”