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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![Re 1/20 and oxygen. Wound closed with drainage and patient sent to ward. Feces discharged freely through tube, but with- out relief to general condition. Died 6 p. m. in spite of re- peated stimulation. No autopsy permitted. Case 17 (Dr. F. B. Harrington) —J. M., man, 42 years. Twelve days ago attack of pain, most marked in epigastrium. Had never had similar attacks. Up and about in a few days. Hight days later had a chill with pain and collapse. Seen on the twelfth day. Temperature 103, pulse 106. Tenderness in right iliac region. OPERATION, Abscess about the appendix, which hung over the brim of the pelvis. The appendix was removed; showed perforation. Patient did well for two or three days, then began to vomit and have return of pain. Seen on fourth day after operation. Abdomen distended and painful. Vomiting; bowels had moved. Death on sixth day after operation. AUTOPSY. Only a local examination was allowed and this had to be done under very adverse circumstances. About two feet. of the beginning of the jejunum was of a blackish brown color, and covered with flakes of fibrin. No genera] peritonitis. Mesen- tery oi affected gut thickened. Intestinal contents bloody. Both arteries and veins of affected mesentery firmly throm- bosed. Cavity of appendix abscess perfectly walled off, and ail the intestines in this neighborhood found normal. Case 18 (Dr. F. B. Harrington).—H. L., man, 40 years, tai- lor, entered Massachusetts General Hospital Sept. 20, 1902. Yesterday morning while at work was seized with sudden, vio- lent abdominal pain, which prostrated him completely. Was nauseated and vomited. Doctor prescribed morphia, without much relief to pain, which continued and grew worse during day. Vomiting increased and continued during day. Condi- tion has been growing gradually worse. Physical Hxamination.—Well-developed man. Pulseless, sighing respiration, no heart murmurs, lungs full of rales, ab- domen distended and painful ail over on pressure, no rigidity, extremities cold. No rectal examination made. Whites 21,000. OPERATION, DR. F. B. HARRINGTON. 14 PER CENT. COCAIN. Six-inch incision along right rectus. Peritoneum dark and free fluid present. Coils of small intestine found flaccid, black and foul smelling. Gangrene found to involve cecum and as- cending colen to hepatic flexure, besides all of the ileum. Con- tinuing from gangrenous areas, the intestine changed gradually to almost normal color. At this stage patient became restless and primary ether was given, also for very poor condition, strychnia, 1/20 gr., with no effect. Small perforation found in small intestine, through which much dark venous blood](https://iiif.wellcomecollection.org/image/b32766634_0036.jp2/full/800%2C/0/default.jpg)
