Appendicitis : its pathology and surgery / by Charles Barrett Lockwood.

  • Lockwood, Charles Barrett, -1914.
Date:
1906
Catalogue details

Licence: In copyright

Credit: Appendicitis : its pathology and surgery / by Charles Barrett Lockwood. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    190/308 page 174
    Iii this case., the lymphatic tissues and lymphatics are most conspicuously at fault. The perfect preservation of the mucosa is rather remarkable, although occurring in a some- what similar case of abscess (Case 55, p. 180), as well as in other cases of lymphangitis and lymphadenitis. The histo- logical examination and clinical history, taken together, suggest very strongly that, as might lie inferred from their course in other parts of the body, appendicular lymphangitis, and lymph- adenitis may end in abscess. Unfortunately, neither this case nor any of the others affords any clear information as to the way in which the abscess originates. Presumably, an acute peritoneal lymphangitis ends in suppuration. On reflection, I am inclined to think that in estimating the possibility of suppuration, more importance ought to have been given to the history of the initial rigor. The subacute type of localised appendicular abscess is illustrated by the following. I am indebted to Mr. Cosens for a very clear and accurate history. Of course, it is to be remembered that the lines of demarcation between chronic, subacute, and acute abscess are purely arbitrary. CASE 53.—Appendicitis with Subacute Peri-append ic id n r Abscess—Abscess in Iliac Fossa.—On July 27, Miss K, school- girl, aged fourteen years, had a paroxysmal pain in the right iliac fossa. The abdominal walls over the iliac fossa were rigid, and acute pain was caused by pressure half-way between the anterior superior spine of the ilium and the umbilicus. JsTo tumour could be felt. The temperature was 100° F. and the pulse 96. The tongue was white and furred, and the bowels constipated. The temperature rose steadily day by day until, on July 30, it was 102-4J F., and the pulse had reached 100 and more, with increased abdominal distension and vomiting. A painful tumour was now felt in the iliac fossa, and the thigh was flexed at the hip-joint. Opium had to be given for the relief of pain. On August 14, the temperature and pulse began to fall and, in a few days, became normal, but the tumour in the iliac fossa did not alter in size, and remained painful on pressure. Fluctuation was entirely absent. Any attempt at walking was followed by pain. Throughout the
    digitised image 1
    digitised image 2
    digitised image 3