Perforation of the colon or rectum during the course of barium-enema examination is estimated to occur in approximately 500 patients annually in the United States. It has been over 30 years since the last collective review on this subject reported a prohibitively high mortality and morbidity. Since that time, much has been learned about the treatment of patients with peritonitis and bowel perforation, many new and more effective antibiotics have become available, and the management of shock has become infinitely more sophisticated. A review of recently reported cases suggests that the mortality rate and possibly the early morbidity have fallen markedly. Late complications such as adhesive small-bowel obstruction and retroperitoneal fibrosis with ureteral stenosis are well described, but data on the incidence of these long-term sequelae are still not available.
shading about one third of the whole opening of the pupil from the retina behind. The outline of the tumor is a single curved line, and its surface apparently smooth and rounded. Diagnosis.-Extravasation of blood under the choroid coat, or the uvca, or both. Treatment.-Absolute rest of the eye from close application, and avoidance of strong daylight and artificial light. Bathing around the orbit frequently with a tepid infusion of opium (gr. 10 to a teacupful of boiling water). March 28th.-No pain, tenderness, nor redness of the globe. Vision improved. The tumor as before, but perhaps mounting not quite so high behind the iris. Ung. iodini daily to left temple. May 26th.-Vision now as good as before the occurrence of the tumor, and since the cut with the stone-that is, very nearly as good as with the sound eye. The tumor is now very sensibly diminished, risiii£r, probably, when the iris is not under the influence of stramonium, not above the margin of the pupil, while its surface is no longer smooth, but corrugated, its superior outline being very irregular and uneven. This result I conceive to be corroborative of the diagnosis.
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