. Journal - American Medical Association . bdomen of four years du-ration. He attributed it to running one day,when he felt something give way in the ilio-caecalregion. He was a strong, muscular young manwith a good familj historj, and besides thosepains had never been sick. The pains had nevercaused vomiting except once, two years ago. Hispulse was 82 ; temp. ° C. Examination revealed no tympanitis, no swell-ing in ileo-caecal region, and only slight tender-ness on deep pressure. Rectal examination re-vealed nothing abnormal. Urine normal. He MEDICAL PROGRESS. 345 never had suffere
. Journal - American Medical Association . bdomen of four years du-ration. He attributed it to running one day,when he felt something give way in the ilio-caecalregion. He was a strong, muscular young manwith a good familj historj, and besides thosepains had never been sick. The pains had nevercaused vomiting except once, two years ago. Hispulse was 82 ; temp. ° C. Examination revealed no tympanitis, no swell-ing in ileo-caecal region, and only slight tender-ness on deep pressure. Rectal examination re-vealed nothing abnormal. Urine normal. He MEDICAL PROGRESS. 345 never had suffered from constipation and veryseldom from diarrhcta. My diagnosis was appendicitis, and an earlyoperation advised. The next morning I was called to see was more pain and very marked tendernessover the caecal region. As he grew no better, heconsented to the operative interference, and wasadmitted in my service in St Benedicts HospitalDecember i8, and prepared for the operation bythorough Natural size, i perforated ext. ulcer. 3, calculus. Operation December ig.—Ether removing the preparatory dressing of iodo-form gauze the parts were washed with ether andthe usual incision for ligation of the common iliacarterj- made. All bleeding points were carefullysecured, and on getting down to the peritonealcavity behind the caecum, a small calculus, thesize of a large bean, was found lying in a table-spoonful of faecal-smelling pus. There was awell organized blood clot extending upwards onthe muscles ; this was carefully removed and gaverise to considerable haemorrhage. The cavity wasthoroughly cleansed and the peritoneum openedfrom behind. The appendix could be felt like afirm body slightly shorter than usual, it was ad-herent to the mesentery, the end was rough andpresented the appearance of everted appendix was brought out in the incision andligated near the caecum with a silk ligature, andthe peritoneal surface sewed over after i
Size: 971px × 2572px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade188, booksubjectmedicine, bookyear1883
