The mode of death from acute intestinal strangulation and chronic intestinal obstruction / by Thomas Bryant.
- Thomas Bryant
- Date:
- 1885
Licence: Public Domain Mark
Credit: The mode of death from acute intestinal strangulation and chronic intestinal obstruction / by Thomas Bryant. 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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![and thick, and coiled over into the right inguinal region, whence it descended into the pelvis, but it had no external outlet. In this case, had right inguinal enterotomy been performed, as in the two fomier cases, tlio sigmoid flexure wonld have been opened. These three cases, therefore, support the suggestion and practice of opening the bowel in the right inguinal region in congenital malformations of the anus and rectum, since, by such an operation, either the crecum or the sigmoid flexure will thereby be opened. I regard this measure as being far preferable to left lumbar colotomy in cases of congenital mal- Ibrniation, and preferable likewise to any blind incision or puncture into the pelvis from an anal cul-de-sac. Again, death may take place fromsimpleToecal impaction; and it is well to remember that this condition may give rise to conditions which may simulate other forms of rectal obstruction. On this account, a careful digi- tal rectal examination should be insisted upon by all practitioners, in cases in which signs or symptoms of obstruction do not yield readily to ordinary means. I have before me thenotes of two casesin which death actually took place as a direct consequence of ftecal obstruction. They are as follows. One was a woman, aged 22 ; the other a child, aged 7 months. The former died from exhaustion ; the latter from peritonitis. Case xxvii. Intestinal OhstriKtion from Fccces.—Caroline V., aged 22, was admitted into Guy's HosiJital on September 3rd, 1870, and died on Seiitember 15th. On August 22nd, she had been seized with pain in the bowels and limbs. She had constipation, and took a])e- rients with some effect. There had been no action afterwards; that is, for eleven days. When she was admitted, the abdomen was flat and flaccid, but not tender. She vomited after taking food. The rectum was empty. Subsequently a tumour was discovered to the right ot the umbilicus, and later a hard cord on the left side of the abdomen. Then the rectum contained fEeces, and an injection brought some away. The day before death, another injection was given, and seven piaits of liquid were thrown up, after which much fsecal matter came away. She was afterwards collapsed. The bowels acted again ; the patient became convulsed, and died. For some days before death, she lay on her right side, complained of great weakness, and could not turn in bed without help. One day she had retention of urine, and a catheter was passed. At the necropsy (196), made six hours after death, the medulla of the cord appeared soft in the middle of the dorsal region. Opposite the upper dorsal vertebraj the grey matter was not distinct, and on the left side it was hollowed out into a cavity. No gi-anule- masses were subsequently discovered. The right lung was hard and airless ; the left lung healthy. The intestines were healthy and pale ; the small intestine was contracted; the cajcum large and floating ; the transverse colon contracted; the splenic flexure distended; the descend- ing colon contracted ; the sigmoid flexure contained hard masses, which could be cut with a knife. The liver was healthy. There was no disease anywhere except in the spinal cord. Case xxvirr. Constipation: Peritonitis: SligM Ulceration of the Large Intestine: Contraction arou'ixd Imi)actcd Faces. —Flora G., aged 7 months, was admitted into Guy's Hospital on October 22nd, 1875 and died on October 27th. She had hdd constipation since birth ; and the](https://iiif.wellcomecollection.org/image/b21519328_0024.jp2/full/800%2C/0/default.jpg)
