Obstruction of the bowel by a large gall stone : operation, recovery / by Francis J. Shepherd.

  • Francis Shepherd
Date:
1904
Catalogue details

Licence: In copyright

Credit: Obstruction of the bowel by a large gall stone : operation, recovery / by Francis J. Shepherd. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    OPERATION—RECOVERY.* BY Francis J. Shkpheuu, M.D., Professor of Anatomy, McGill University, and Surgeon to the Montreal Genera Hospital. The following case is of sufficient interest, both on account of its rarity and importance, to bring before this Society. History: Mrs. H., a widow, aet. 72, rather stout, has never been seriously ill and there is no history of gall-stone colic. Some days ago she slipped and felt sometliing give way in her abdomen; she was fairly well afterwards but always felt as if there was sometliing amiss in the abdomen. On Sunday, February 8th, 1903, after a hearty supper, she went to bed and was awakened Monday morning by an attack of diar- rhoea, she had three stools. Soon vomiting came on but no nausea; this continued all day and was without effort, more like regurgitation of intestinal contents. Dr. Gordon Campbell saw her on Monday, purgatives were administered without avail; pulse and temperature normal; no flatus had passed since Sunday. Dr. Campbell, recogniz- ing the case as one of obstruction, called me in Tuesday evening. All that day she had been vomiting and had suffered pain, probably from the purgatives administered. When I saw the patient her pulse was full, 76, temperature normal, no distension, but some tenderness about the umbilical region on pressure. Vomiting was continuous, without effort and was not preceded by nausea. Seeing that there was evi- dently obstruction due toi some unknoivn cause, I advised an explora- tory incision. She was removed to the Montreal General Hospital and operation was commenced at 10.30 p.m. The incision was below the umbilicus and of considerable length because' of the stoutness of the patient. On opening the peritoneal cavity and introducing my hand I almost immediately came upon a hard substance within the bowel The bowel was pulled out and it was found that a solid body was wedged into it like a cork. Immediately about it the bowel was dark colored. The contained substance would not be forced on but was easily pushed back, and as soon as healthy bowel was reached an in- cision was made in the long axis of the bowel, opposite the mesenteric attachment, and the stone removed. The incision in the bowel was sutured in two layers with silk, first * Bead before the Montreal Medico-Chirurgical Society, March 20,1903.