436 
DEPARTMENT OF SURGERY. 
able results, such as tension upon an omentum or mesentery ; 
enteralgia, resulting from impaired nerve function; hyper¬ 
trophy of the tissues surrounding the cicatrix ; or a stricture 
caused by the cicatrix, are all conditions that may follow this 
operation. 
The Murphy Button (Rev., XXIV., 3, p. 216) can be used in 
this operation to a very good advantage. It can be adjusted in 
less time than it requires to suture the ends together properly, 
and in this way the operation may be shortened, which is gen¬ 
erally a long tedious procedure, especially when a large portion 
of the intestine is resected. 
3. Intestinal Approximation. — This operation is similar 
to the one just described, with but a small part of the in¬ 
testine resected, instead of a whole or greater part of a division. 
The indications are usually abdominal wounds, punctures or 
pathological conditions involving all the coats of the intestine. 
The wounds may be caused by an accidental injury in which 
the abdomen is opened and the intestine prolapsed and injured 
and perforated before this secondary accident can be prevented ; 
or, it may be injured while still in the cavity, as in case of a 
gunshot wound, or a wound inflicted with a sharp cutting in¬ 
strument such as a knife, chisel, corn-cutter or scythe. Punc¬ 
tures of the abdomen are more common than incised wounds, 
and they may be caused by animals running into or falling 
upon sharp or blunt pointed objects ; or may be gored by cattle. 
If the intestine is injured in this manner, the injury is gener¬ 
ally a lacerated wound, a bruise, or a puncture, and a resection 
is only necessary when the injury involves the greater part of 
the circumference of the intestine. There might be classed 
among the accidental wounds, rupture of the intestine ( Enter - 
orrhesis ), which is sometimes caused by torsion of the body when 
the intestine is united to the abdominal walls ; in such cases a re¬ 
section may be necessary in order to repair the injury properly. 
Among th ^pathological conditions that may require a resection 
may be included tumors of the intestine (' Enteroncus ); septiccon- 
dition of the intestine ( Enteropyosis ) ; gangrene of the intestine ; 
and stenosis of the intestine (Enterostenosis) , which may be 
due to a constriction of the circular muscular fibres or a hyper¬ 
trophy of the walls. There are only a few cases in abdominal 
or intestinal injuries in which it is possible to determine 
whether or not a resection is necessary without an exploration 
of the abdominal cavity. 
Operation .—The patient must be cast, properly secured, 
