The medical diseases of children . ntion, and illness, the patients appear to survive. The relationship of these three groups of cases to each other I donot attempt to explain, merely setting them down as I have seen them. 284 DISEASES OP THE DIGESTIVE SYSTEM Morbid Anatomy-—As a rule the whole of the large bowel isaffected (Fig. 55), but the changes may be limited to the sigmoid. Inthe affected part the bowel is enormously dilated, its walls are thickened,and its mucosa reddened and thickened. In fatal cases large massesof fa?cal material are found within the bowel, often adherent to, and occ
The medical diseases of children . ntion, and illness, the patients appear to survive. The relationship of these three groups of cases to each other I donot attempt to explain, merely setting them down as I have seen them. 284 DISEASES OP THE DIGESTIVE SYSTEM Morbid Anatomy-—As a rule the whole of the large bowel isaffected (Fig. 55), but the changes may be limited to the sigmoid. Inthe affected part the bowel is enormously dilated, its walls are thickened,and its mucosa reddened and thickened. In fatal cases large massesof fa?cal material are found within the bowel, often adherent to, and occa-sionally producing ulceration of, its wall. In babies these masses arehard in consistency and bright yellow in colour. The other changesalready noted may be present. Diagnosis.—This is a matter of difficulty in very young suspected, the capacity of the colon may be gauged by theinjection of warm saline solution. Where peristalsis is present, thecondition may be mistaken for hypertrophic pyloric stenosis, as in. Fg- 55-—Hirschsprungs Disease. both diseases left-to-right peristalsis is seen. In Hirschsprungsdisease the waves pass at a low level across the abdomen, while thesymptoms are rectal rather than gastric. In older subjects the verylarge stools and the marked decrease of the abdominal distentionfollowing an action of the bowels are very characteristic. Prognosis.—Sufficient has been said on this subject under thesymptomatology of the various groups of cases described. Treatment.—In young infants this is a matter of great is serious constipation, and when the bowels are opened severeor fatal collapse may ensue. For this reason, therefore, aperients mustbe used cautiously, and be combined with rectal irrigation (rather than DILATATION OF THE COLON 285 enemata) and abdominal massage. In older children the same linesof treatment are to be used, but with greater freedom than in tetany and other nervous symptoms subside wit
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectpediatrics, bookyear1
