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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    danger is greater when the appendix is not removed, because it, too, may form adhesions with other organs and become a strangulating band. This had occurred in a case upon which I operated for acute intestinal obstruction. Unfortunately the loop of intestine was either gangrenous or on the point of becoming so, and had to be excised. The patient seemed likely to recover until the junction gave way on the third day. The inflammatory adhesions of the peritoneum tend to disappear in a remarkable manner. This is shown by the following case, which also illustrates several additional points, and I have therefore quoted it at length :— Case 83.—The patient was a postman, aged twenty-five years.1 His illness began suddenly, without premonitory symptoms, on June 3, 1894. He was seized with violent pains in the abdomen, his bowels ceased to act, and he had occasional vomiting. He was treated with opium and a liquid diet. I saw him on June 11 in the Great Northern Hospital. His temperature was 100-2° F., where it remained until the 13th, when it fell to 98-6° F. Throughout the rest of his illness, it never rose beyond 9 9'4° F. His pulse was 88, and never exceeded !t(i per minute. He was exceedingly ill. with an anxious expression, and was suffering -real pain. The abdomen was tense, and did not move with respiration. In the right iliac region, it was more distended than elsewhere, and there was an induration about the caecum, with slight oedema and redness of the skin. It was obvious that he was suffering from typhlitis, and as I had seen similar cases recede, leeches were applied, and afterwards warm fomentations. During the 12th, 13th, and 14th the iliac swelling disappeared, but his condition became decidedly worse. The abdomen was more distended. The bowels did not act after the enemas, and it was questionable whether any flatus escaped. The pain was most severe in the lower abdomen, and was only relieved by opium. A tense fluctuating swelling was also felt in the recto-vesical pouch. As it was obvious that the patient would die, if unrelieved, on June 15, 1 opened the abdomen in the right linea semilunaris with the idea of finding the 1 The Surgical Treatment of Different Septic Peritonitis, byC. B. Lock- wood, Medico-Cliirurykal Transaction*, vol. l.wviii. ]8P5, ]>. 16,
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