. A practical treatise on medical diagnosis for students and physicians . en earlier. The pain and collapse are prob-ably due to pressure of the effused blood upon the coeliac plexus; while 1110 DISEASES OF THE LIVER, SPLEEN, AND PANCREAS. the fever and the appearances of intoxication are probably the result ofinfection. Violent delirium resembling acute mania and not unlike thatseen in atropine-poisoning, occurs in some instances. Symptoms oflocalized peritonitis arise, and if the patient lives, the tumor increasesto a considerable size. Diagnosis. The symptoms resemble those of acute intesti
. A practical treatise on medical diagnosis for students and physicians . en earlier. The pain and collapse are prob-ably due to pressure of the effused blood upon the coeliac plexus; while 1110 DISEASES OF THE LIVER, SPLEEN, AND PANCREAS. the fever and the appearances of intoxication are probably the result ofinfection. Violent delirium resembling acute mania and not unlike thatseen in atropine-poisoning, occurs in some instances. Symptoms oflocalized peritonitis arise, and if the patient lives, the tumor increasesto a considerable size. Diagnosis. The symptoms resemble those of acute intestinal obstruction,intoxication with irritant poison, or -perforation of the gastro-intestinal orbiliary tract, or an attack of hepatic colic. In several instances laparotomyhas been performed for the relief of supposed obstruction. The intensepain in the epigastrium, with violent vomiting and distention of the upperabdomen, without a possible cause for obstruction, are favorable to aeutepancreatitis. The difficulty of diagnosis, however, is so great that resort Fig. Tumor of the pancreas. to laparotomy is justifiable in order to determine the exact nature of thecondition. In a most interesting case reported by W. S. Thayer, the diag-nosis of acute pancreatitis (confirmed by laparotomy) was based upon thehistory of previous attacks of pancreatic pain, with fever, vomiting, andcollapse, occurring in an adult who was over-fat and an alcoholic ; theexclusion of disease in other organs and the absence of a history of gall-stones, gastric ulcer, or abscess from other causes ; the occurrence of pain ;the presence of a deep-seated tumor with indistinct signs of fluctuation,which was not movable with respiration, and the dulness of which was GANQBENOUS PANCREATITIS. 1111 not continuous with, or of the same character as that of adjacent solidorgans. Epigastric tympany was also a point in favor of pancreaticdisease. The accompanying figure indicates the site of the tumor inThayers cas
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