436

MEDICAL

SENTINEL

GASTROPTOSIS: A METHOD OF SUSPENDING

THE STOMACH IN A HAMMOCK MADE

OF THE GREAT OMENTUM

By R. C. COFFEY, M.D.
Portland, Oregon

I

Owing to a lack of time, I will
not present a paper, but will briefly
report two cases of Gastroptosis,
which I have treated by a method,
as far as I know, entirely original.
The paper
Philadelphia Medical Journal.
in full will appear in the
will, therefore, not burden you by
relating the cases, except to show
some drawings representing them
before and after operation, and dia‍
grams demonstrating the method
of operating, and the anatomical
reasons which make the operation

a success.

The three first drawings represent the first case, which was operated upon last November, at the North Pacific Sanatorium. It was reported to the Portland Medical Society in December, 1901, and to the Whitman County (Washington) Medical Society in January, 1902. Both cases were absolute invalids and great sufferers. The symptoms I will omit at present.

Cut I represents enlargement showing externally after the patient was under the anaesthetic and the wall relaxed.

Cut II shows the stomach as it appeared after the abdomen had been opened.

was

It will be seen that the lesser curvature of the stomach about two inches below the unbiliThe great omentum was adherent to the peritoneum of the an

cus.

ly tenting over the pelvic cavity. Strong bands of adhesion, as terior wall of the pelvis, completefirmly in the upper part of the shown in cut, held the stomach pelvis. forced back into its position and After the adhesions were broken up, the stomach was easily terrupted chromicized catgut susutured there, by placing three intures through the omentum, about to the peritoneum of the abdominal an inch below the greater curvature of the stomach, and stitching wall, as show in Cut III.

This patient was relieved of her
trouble within forty-eight hours
from the time of the operation, and
is now (almost a year from the
time of the operation) in perfect
The cure was immediate, complete,
health, and as far as we can tell,
the stomach is in perfect position.
and as it seems, permanent.

valid for several years. The greater
Cut IV represents another case,
which had practically been in in-
curvature of the stomach in this
case was about two inches below
the umbilicus.
lon was displaced into the pelvis.
The transverse co-
lying parallel to the cecum, and
tied down by very dense adhesions
fore, for
all the way along, the patient hav-
through a medium incision, which
ing been operated upon a year be-
recurrent appendicitis
was made for the purpose of sus-

greater

Cut IV. Case No. 2, showing the
curvature of the stomach two inches be-
low the umbilicus. Transverse and as-
cending colon adherent together and in-
volving the omentum.

pect that their old trouble was re-
turning. Having first obtained
clinical results, I have since made
a careful study of the anatomy of
the peritoneum, and have been fully

tines is histologically composed of four layers of peritoneum, forming a sac, the walls of which are composed of fat, blood vessels and lymphatics, and enclosed in peri