Mesenteric embolism and thrombosis : a study of two hundred and fourteen cases / James Marsh Jackson, Charles Allen Porter and William Carter Quimby.
- Jackson, James Marsh.
- Date:
- 1904
Licence: Public Domain Mark
Credit: Mesenteric embolism and thrombosis : a study of two hundred and fourteen cases / James Marsh Jackson, Charles Allen Porter and William Carter Quimby. Source: Wellcome Collection.
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![cause of the distension. Patient drowsy, lips dry, breath foul and tongue coated. Temperature 100, pulse weak, 110-120. Clinical Diagnosis.—Carcinoma of descending colon. OPERATION. DR. M. H. RICHARDSON. ETHER. March 26. <A three-inch incision in median line, at level of umbilicus. Hard mass felt by examining hand, at lower end of descending colon. Wound then closed with silkworm gut sutures. Patient then turned on right side, and incision made down and forwar:! from costal border to crest of ileum, follow- ing outer edge of quadratus lumborum. Descending colon grasped, purse-string suture placed in it, and gut united to skin with sutures. Opening then made in intestines, and a Mixter tube inserted. Rest of wound then closed. Patient’s condition did not warrant doing a resection. The mass was a hard, firm tumor, apparently filling the whole of the lumen, about the size of a hen’s egg. An enlarged mesen- teric gland also felt. About sixteen ounces of liquid feces and gas escaped from the tube. March 27. Very comfortable night. Vomited once, fecal] in character. ‘Tube draining freely, and distention gone entirely. March 28. Comfortable. Taking liquids well. No distention. March 29. Temperature 100. Condition improving. Some leakage about tube. March 31. Pulse weak and intermittent. Has failed much during last two days. April 2. Pulse better, and general condition improved. April 8. Temperature 101.2. This morning some nausea. April 11. Condition much better. Sensorium clear. April 24. As well as usual last night. At 5 a. m. sudden labored breathing. Cold extremities. Imperceptible pulse. In spite of forced stimulation, died in less than an hour. AUTOPSY. DR. J. H. WRIGHT. April 24, 1897. Adenocarcinoma, stricture of descending colon, with suppuration of neighboring retroperitoneal tissue. Lumbar colotomy. Laparotomy wound. Arteriosclerosis with thrombi of aorta and superior mesenteric artery, with begin- ning infarction of small intestine. Anemic and hemorrhagic infarcts of kidneys. Arteriosclerotic atrophy of kidneys. Ovarian cystoma. In abdominal aorta, a mass about the size of the little finger, not adherent, comprised of friable, grayish material, intermixed with black blood clot, in variable proportions. In superior mesenteric artery, at ori- gin, a grayish-red, friable, firm, adherent mass, filling the ves- sel. The aorta shows rather numerous yellow patches, but no caleareous plates. The thoracic portion shows a gray-red clot adherent to intima, in the neighborhood of a smaJl yellowish patch. The small intestines, for the most part, lie in the pelvic cavity. They are rather dark colored, not black, their serous](https://iiif.wellcomecollection.org/image/b32766634_0034.jp2/full/800%2C/0/default.jpg)
