Licence: Public Domain Mark
Credit: On the causes of death after lithotomy / by Thomas Bryant. 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.
14/24 page 14
![clironic inflammation; the cortex was soft, red, and contracted, and full of purulent deposits. The pelves contained pus, which distended them. Ureters were dilated, and mucous membrane inflamed. Bladder was contracted, and externally- looked healthy; its interior presented two portions, having very different aspects ; close to the neck was a pouch where the calculus had been impacted, and above this the more healthy-looking bladder which had held the urine. This was somewhat thickened, and its mucous membrane inflamed. The lower portion which surrounded the sac was raised, soft, and vascular when in contact with the stone, and the coats beneath were soft. Round the bladder, in the cellular tissue, was some brown, watery, purulent fluid, the result of inflam- mation. The prostate was somewhat enlarged and freely divided. In the above case it is clear that as the patient had only survived the operation fifteen hours, the pelvic cellulitis must have been the result of the presence of the stone, and not the consequence of any operative interference—well bearing out the opinion expressed in a former page. Case xxix.—A man, set. 22, after lithotomy, died; although the period and symptoms are not mentioned. The peritoneum was found acutely inflamed. The left kidney was small, and its glandular substance was nearly absorbed; j its pelvis was enlai'ged, and contained a calculus the size of a||( swan-shot. The right was larger than natural, soft, pale, andB flabby; but contained no trace of distension or obstruction. H Left ui’eter large and thin; but nowhere evincing any recent■ obstruction. Bladder but little thickened, mucous membrane ■ but little altered. Prostate cleanly cut, and but very* moderately. The cellular tissue at base of bladder infiltrated ■ with pus. Wound sloughing. Other viscera healthy. K VI. Pelvic Cellulitis associated with accidental causes. , 1 The three following cases afford good instances of thefc accidents with which the operation of lithotomy may beK] attended. The first is a case where the rectum was punctured ;K](https://iiif.wellcomecollection.org/image/b22329286_0014.jp2/full/800%2C/0/default.jpg)
