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.

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    Owing to these difficulties the abdominal wound may have to be made longer, and there is a greater danger of ventral hernia, The dangers of ventral hernia are also increased, because the wound is more likely to suppurate. The wound may be infected whilst the inflamed appendix is being with- drawn, or it may become infected by the inflamed peritoneum, which will have bacteria in it for many days after the sub- sidence of the attack. The following case bears upon this point:— Case 69.—Appendicitis with Interstitial Hcemorrhage— Perityphlitis, involving the Bight Broad Ligament of the Uterus —Bacteria in the Peritoneal Exudation many Days after the Subsidence of the Attar/,-.—The patient was a robust young lady, aged eighteen years. Towards the end of 1807, I saw her in the midst of her second attack of appendicitis. She bad a high temperature and rapid pulse,1 abdominal distension, constipation, vomiting, and great pain m the right iliac fossa. The abdominal wall in the right iliac region was very rigid, and acutely painful on pressure. A tender ovoid tumour was afterwards felt at the site of the appendix. A curious doughy swelling could be felt per rectum, and this, I thought, was the right broad ligament inflamed and ^edematous. The attack of appendicitis subsided, and, after the lapse of a week, the rectal swelling had gradually disappeared. The vermiform appendix was removed in the usual way. It was most difficult to find, being hidden away beneath the caecum, to which it was adherent, as well as to the periton- eum lining the iliac fossa. In removing the appendix, a small rent was made in the peritoneal and muscular coats of the eanim. which required the application of a suture. The recently inflamed peritoneum bled a good deal, so a rubber drain was inserted. This was removed at the end of forty-eight hours, and a rapid recovery ensued, without any trace of suppuration. NTow, in this case, there can be no doubt as to the severity of the attacks, nor that they were accompanied with extensive and widespread perityphlitis. In the appendix, the following changes are found. The peritonea] surface is rough and denuded of endo- 1 I am writing from memory, ami regret that I cannot be more precise.
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