. Lectures on the diagnosis of abdominal tumors, delivered to the post-graduate class of Johns Hopkins university, 1893. tal margin in the nip-ple line. The greatest prominence is just below the point of thetenth rib. On first palpating it this morning there was at the lowermargin a prominent rounded, ridge-like mass, firm and hard, whichgradually disappeared, feeling as if it were a tubular, muscularstructure in contraction. Again this morning gas was felt bub-bling through the mass. Percussion over it gave flat tympany;slight change noted in rolling the patient over on the left side. Ata sec
. Lectures on the diagnosis of abdominal tumors, delivered to the post-graduate class of Johns Hopkins university, 1893. tal margin in the nip-ple line. The greatest prominence is just below the point of thetenth rib. On first palpating it this morning there was at the lowermargin a prominent rounded, ridge-like mass, firm and hard, whichgradually disappeared, feeling as if it were a tubular, muscularstructure in contraction. Again this morning gas was felt bub-bling through the mass. Percussion over it gave flat tympany;slight change noted in rolling the patient over on the left side. Ata second visit to-day there were noticed for the first time waves ofperistalsis crossing the upper abdomen from left to right, and the 130 THE DIAGNOSIS OF ABDOMINAL TUMORS. outlines of the stomach could he distinctly seen, the lower borderreaching to the navel. At the time of the passing of the waves thewalls of the stomach became firm, and bubbles of gas could be feltpassing through the tumor. 20th.—The signs of dilatation of the stomach have been for thepast few days unusually distinct. He has had vomiting of large. quantities of liquid. The amount of urinary secretion is veryscanty. He sank gradually and died on the 20th. Autopsy.—By Dr. Flexner. On opening the abdomen the stom-ach was seen to be greatly dilated, reaching considerably below the TUMORS OF THE INTESTINE. 131 level of the navel (Fig. 35). In the right hypochondriac region atumor mass was adherent in part to the anterior abdominal wall,just between the costal margin and the crest of the ilium. Just be-low the hepatic flexure of the colon there was a tumor the size of anorange completely encircling the bowel. It was seven centimetresin length and eight centimetres in circumference. The coats wereuniformly infiltrated and the tissue looked infiltrated witli inner surface was ulcerated and the lumen of the bowel nothere narrow. The caecum and ascending colon were opened in the hepatic flexure th
Size: 1481px × 1687px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, bookidlecturesondi, bookyear1901
