Irreducible Rupture

Categories: Digestive Organs

This is when the rupture cannot be returned into
the abdominal cavity, and it is without any symptoms of strangulation.

They are of long standing and of a large size. This condition is often due

to carelessness of a patient in not keeping in a reducible rupture with a

proper support. Adhesions form, holding the rupture. Even if it is small,

it gives rise to much discomfort and the patient is always in danger of

strangulation f the rupture.



Operation for radical cure is generally a success.







Strangulation Hernia or Rupture. This means the rupture is so tightly

constricted that it cannot be returned into the abdominal cavity, and its

circulation is interfered with; then there is not only obstruction to the

passage of the feces, but also an arrest of circulation in the protruded

portion of bowel which, if not relieved, results in gangrene and death.

This occurs more often in old than in recent ruptures and more often in

congenital than in acquired rupture.



Symptoms. Sudden and complete constipation with persistent vomiting. The

lump may be tense, hard and irreducible. Then there is faintness,

collapse; severe abdominal pain, complete constipation, with no gas

passing, then vomiting, at first of food, then of the bile-stained fluid

and finally of fluid with a bowel odor. All these symptoms increase and

the patient gradually sinks from exhaustion in eight or nine days, though

in very acute cases the patient may die within forty-eight hours.



MOTHERS' REMEDIES. Strangulated Hernia, Hop Poultice for. "A large warm

poultice of hops over the abdomen will be found one of the best known

means of relieving strangulated hernia."



PHYSICIANS' TREATMENT. It must be reduced or an operation must be

performed and soon.



To reduce. The patient is put under an anesthetic and placed on his back

with the hips (pelvis) raised and the thigh of the affected side flexed,

bent up and rotated inward if the rupture be inguinal or femoral. This



motion relaxes the parts. The neck of the sac is then seized with the

thumb and fingers of one hand, and thus fixed, while with the other hand,

the operator endeavors to return the strangulated gut by gentle pressure

in the proper direction. In femoral rupture, this is at first downward, to

bring the gut opposite the opening then backward and then upward. In groin

(inguinal) rupture it is usually slightly upward and outward. It must be

coaxed, kneaded and squeezed carefully. Care must be taken. If it cannot

be returned in from five to ten minutes no further time should be wasted,

but an operation should be performed immediately. This consists in cutting

down to the constriction and through it, thus allowing the rupture to be

reduced.



The patient should be kept in bed and treated the same way as for other

abdominal operations.



Caution. Persons with rupture must be very careful not to lift or fall.

If a support is worn it must fit perfectly and be worn with comfort.