THE PURPOSE of this paper is to present a discussion of the indications for and the results of the several types of surgical management of regional enteritis. An attempt will be made to evaluate the following procedures: ( 1 ) conservatism; (2) vagotomy; (3) ileocolostomy; (4) ileotransverse colostomy with exclusion, and (5) resection.
1. Conservatism is reserved for those patients on whom a laparotomy is performed under a mistaken diagnosis of appendicitis or for those in whom the disease is found to be too far advanced for surgical treatment. Usually the ileum is found in a stage of acute inflammation with red edematous bowel and acutely enlarged mesenteric nodes. Surgical treatment of the enteritis at this time is more hazardous, and it is generally agreed that the operation should be terminated with or without removal of the appendix. Some contend that removal of the appendix at this time promotes fistula formation; others