The practice of pediatrics . dules occur in any part of the peritoneum and in the abdominal walls;the process may lead to suppuration and the formation of fistula1, mostoften in the neighborhood of the umbilicus. Advanced tuberculouslesions are found in the other viscera, especially the lungs. The constitutional symptoms in this condition are usually those ofa general tuberculosis, with considerable fever; it may be of the hectictype: rapid pulse, rapid respiration, sweating, and marked abdominal symptoms consist of indigestion, possibly with vomiting,more or less colicky pain
The practice of pediatrics . dules occur in any part of the peritoneum and in the abdominal walls;the process may lead to suppuration and the formation of fistula1, mostoften in the neighborhood of the umbilicus. Advanced tuberculouslesions are found in the other viscera, especially the lungs. The constitutional symptoms in this condition are usually those ofa general tuberculosis, with considerable fever; it may be of the hectictype: rapid pulse, rapid respiration, sweating, and marked abdominal symptoms consist of indigestion, possibly with vomiting,more or less colicky pain in the abdomen, and constipation or there are tuberculous ulcers in the intestine, there will occasionally TUBERCULOSIS 375 be blood in the stools. The abdomen is distended, tense; nodules mayoccasionally be seen beneath the skin. Unless the effusion into theperitoneum is very large the signs are not those of ascites, but of scatteredareas of dulness from encysted fluid, with intervening areas of tympany. Fig. 76. Intestines removed en masse from a case of tuberculous peritonitis. Note the thickened omentumcontaining tuberculous nodules and the matting together of the intestines. Often the abdomen has a rather characteristic doughy feel and nodulesmay be detected here and there in it. In some instances there arefistulae, especially near the umbilicus, discharging characteristic tuber-culous pus. In other cases the fistula? may open into the bowel. Thecourse of the disease in this form is steadily progressive, the patients 376 INFECTIOUS DISEASES suffering not alone from the peritoneal but from the general tuberculouslesions. The duration is usually two or three months. The patientsdie of exhaustion, or from new complications, such as tuberculous menin-gitis, rarely from the peritoneal process itself. 4. Fibrous Form.—In a considerable proportion of all the cases oftuberculous peritonitis there is no effusion of serum or pus, hut the Fig. 77
Size: 1267px × 1973px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, booksubjectchildren, bookyear190
