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.

    5/8 (page 5)
    the eighth rib and extended forwards as far as the sixth rib in the posterior axillary line j that in front of this there was stomach resonance as high as the fifth rib on the mid-axillary line; and that no tumour was to be felt below the ribs. The intercostal spaces were collapsed. Four days after the aspiration (September 14) the physical signs were the same as before the fluid was drawn off. About this patient there is little more to be said ; he gradually improved in general condition, though suffering occasional attacks of sharp pain in the abdomen, modified apparently by position, but he had no more actual sickness. The tempera- ture, which rose to 100° the day after the aspiration, came down on the following day to normal and remained so until his discharge on October 9. There were still signs of unnatural distension of the stomach, the tympanic note varying in extent but sometimes reaching the third interspace. The dulness in the back and axilla did not alter, but breath-sounds could be heard over the dull area. The intercostal spaces were again collapsed and no tumour was to be felt in the abdomen. He has kept well since, though he appeared the other day at the hospital complaining of some pain in the abdomen, again of a dragging character, due, I believe, to a left inguinal hernia, for which he was supplied with a truss. It seems almost useless to speculate upon the exact nature of the injury in this case. I do not think that the fluid was in the pleura, though it is not possible to prove the contrary. I think it most probable that it was contained in a cyst above the kidney and resulted from a laceration of the organ, and that by pressure on the stomach it gave rise to the trouble- some gastric symptoms, and also as it extended backwards it pressed the diaphragm against the ribs and so caused the dulness in the back and axilla. The possibility of the exist- ence of a diaphragmatic hernia was discussed, but the idea was discarded. The third case is not like either of the others, and is perhaps more remarkable than the last. W. W-, a boy set. 7 (No. in hospital register 2450), was knocked down by a van-horse about September 23, 1885, and the front wheel of the van pressed against him on the right side between the iliac crest and the ribs, but did not pass over him. He remembered being pulled out and thinks that he could have walked home. He was seen by Mr. Adams Clarke, of Bushey, who found him suffering from pain in the abdomen,