Some cases of abdominal cysts following injury / by Rickman John Godlee.

  • Godlee, Rickman John, Sir, 1849-1925.
Date:
[1887]
Catalogue details

Licence: Public Domain Mark

Credit: Some cases of abdominal cysts following injury / by Rickman John Godlee. 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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    off and was on each occasion found to be smoky, but after this it was passed naturally and was normal. Vomiting of bilious matter, not continued nor excessive, lasted till the 18th. The temperature rose to 100° on the second day and gradually mounted to 101 8° on the sixth day. After the eighth day it did not rise to 100°, but it remained over 99° till the day before his discharge, July 29, sixteen days after the accident. He became slightly jaundiced during his stay in the hospital, but left it feeling fairly comfortable and apparently without any tumour or dulness in either flank. On August 12, a fortnight after his discharge, he came back, telling us that since that time he had been occasionally sick after taking solid food and had suffered slightly from diarrhoea. We found him pyrexial, with a temperature of 100° to 1018°, with the abdomen slightly but uniformly dis- tended and giving no signs of free fluid nor of a localized cyst; there was pain, however, in the hypogastric region and the left flank. He was put upon spoon diet and the vomiting did not recur. Hot fomentations were applied to the belly and the symptoms referred to this region sub- sided. There was no trouble of any kind with the water. In about four days the temperature came down almost to normal. Between the date of admission and September 10, nearly a month, he was kept mostly in bed, and for a considerable part of the time on spoon diet, as it seemed clear that vomit- ing was on more than one occasion started by giving him solid food and allowing him to get about. Ultimately, however, this restriction was relaxed and the vomiting did not reappear. In the meanwhile a tumour developed itself, projecting slightly below the margin of the ribs on the left side, dull on per- cussion (the dulness extending in the axilla to the level of the nipples) and apparently pushing the heart up, for marked pulsation was apparent in the second intercostal space. On September 10 an aspirator needle was passed through the seventh intercostal space a little in front of the line of the posterior axillary fold and so no doubt through the attach- ment of the diaphragm. It entered a cyst, and 7 oz. of turbid fluid were drawn off, containing a mere trace of urea (•01 per cent.), a certain amount of albumen, and showing, under the microscope, blood-corpuscles, some indefinite granular cells, and some flat epithelium. On the following day it is noted that the heart's apex was beating in the third space; that dulness in the back began at