Notes on the surgical treatment of haematuria and rupture of the bladder / by Reginald Harrison.

  • Reginald Harrison
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Notes on the surgical treatment of haematuria and rupture of the bladder / by Reginald Harrison. 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.

    12/18 page 10
    some doubt as to the precise position of the rupture relatively to the peritoneum. I therefore determined to explore the bladder with my finger by a median opening from the peri- neum, and to shape any subsequent proceeding in accordance with the result. This I accordingly did, and discovered that the rupture was extra-peritoneal, and situated on the anterior wall a little behind the prostate. The opening admitted the index finger, by which a fracture of the pubic arch could be felt. The position of the rupture decided what should be done. A large lithotomy tube was passed into the bladder from the perineum, through which drainage could be carried on.—13th, 10 A.M.: The patient had passed a restless night, but was not in pain ; the urine came away freely, slightly tinged with blood. 5 P.M.: Much pain complained of in the lower part of the abdomen : pulse 95 ; temperature 99°. He vomited everything, and complained intensely of thirst. 8 p.m. : As the pain and vomiting continued, nothing was given but ice and small doses of opium.—14th, 2 a.m. : Complains of much pain over lower part of the abdomen; fomentations applied^ pulse increasing in frequency; temperature 101°; urine draining away freely, and natural in appearance. At 2.30 a.m. the flow suddenly ceased; it was thought the tube might be blocked, but this was not the case. At 8.30 a.m. the patient died suddenly, the abdomen remaining soft and compressible to the last. It was subsequently ascertained that the patient had only left his bed a fortnight previously, after an attack of scarlet fever. He lived thirty-two hours after the cystotomy, during twenty-seven hours of which urine was freely passed through the tube. No urine seemed to have been excreted during the last five hours of life. The operation of opening the bladder was performed on a staff; it occupied only a few seconds, and may be said to have been bloodless. Pust-mortem Examination.—On opening the abdomen there were found signs of commencing peritonitis. There was some serous fluid in the pelvis, but no blood. The visceral peritoneum, covering some coils of small intestine in the pelvis, had lost its gloss, and the whole of the pelvic peritoneum was rough and
    digitised image 1
    digitised image 2
    digitised image 3