. A practical treatise on medical diagnosis for students and physicians . the sigmoid flexure or descend- GAjSTROPTOSLy. 517 ing colon, volvulus, tuberculous peritonitis, or enlargement or displace-ment of the kidney or spleen (q. v.). Fecal abscess also may occur here?and the tumor of intussusception may be found on the left side. Enlargement about the centre of the abdomen or umbilical region maybe due to umbilical hernia ; to gastroptosis, or a floating kidney, spleen,or liver; to cancer of the stomach, liver, or intestine, or sarcoma of theretroperitoneal glands ; to hydatid disease of the
. A practical treatise on medical diagnosis for students and physicians . the sigmoid flexure or descend- GAjSTROPTOSLy. 517 ing colon, volvulus, tuberculous peritonitis, or enlargement or displace-ment of the kidney or spleen (q. v.). Fecal abscess also may occur here?and the tumor of intussusception may be found on the left side. Enlargement about the centre of the abdomen or umbilical region maybe due to umbilical hernia ; to gastroptosis, or a floating kidney, spleen,or liver; to cancer of the stomach, liver, or intestine, or sarcoma of theretroperitoneal glands ; to hydatid disease of the liver or a tumor of thegall-bladder; or finally to tuberculous disease of the omentum or mesen-teric glands (tabes mesenterica). In gastroptosis (see Fig. 187) there is often an appearance that isquite characteristic—an elastic swelling suggesting the stomach by itsshape, and presenting at or just below the umbilicus while the epi-gastrium is flattened. A similar appearance is seen in some cases ofgastric dilatation and in retroperitoneal sarcoma. Enlargement of the. Stomach inflated, lowing g astz o ptosis. umbilical region associated with a more prominent swelling about thelower end of the sternum is observed in cancer of the stomach ; in can-cer or other disease—such as hydatid cyst—of the liver or gall-bladderthe enlargement extends to the ribs on the right side ; while effusionsinto the lesser peritoneal cavity and disease of the spleen and pancreascause enlargement extending from the umbilicus to the left costal projection of the vertebrse must not be mistaken for a mesenterica occurs nearly always in children and presents thephysical signs and symptoms of tuberculous peritonitis, with the additionthat enlarged mesenteric glands may sometimes be felt. The childrengrow pale and anaemic and waste away; they have apparently causelessattacks of diarrhcea productive of foul-smelling stools containing much 518 PHYSICAL DIAGNOSIS OF DISEASES WITHI
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