Abstract of a paper 'A resume of the subject of actinomycosis, with report of a case of actinomycosis abdominalis' / by A. Vanderveer and Arthur W. Elting.

  • Vander Veer, A. (Albert), 1841-1929.
Date:
1901
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Licence: In copyright

Credit: Abstract of a paper 'A resume of the subject of actinomycosis, with report of a case of actinomycosis abdominalis' / by A. Vanderveer and Arthur W. Elting. 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.

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    although cases have been reported by Bostrom, Hesse, Billroth and others. The prostate has, in a few instances, been in- volved by extension of the disease from the rectum. In women the pelvic viscera have sometimes been extensively involved by extension of the process from the primary intestinal focus. In all the literature Grill was unable to find a single authentic case where abdominal actinomyco- sis had extended through the lymph channels. Metastasis, in the great majority of cases, takes place through the veins rather than the arteries. Among the secondary lesions of abdominal acti- nomycosis those of the liver are the most frequent, involvement occurring either by continuity, conti- guity or metastasis. In 20 of the 30 cases of hepatic actinomycosis collected by Aribaud the primary focus was intestinal. In from 50 to 60% of abdominal actinomycosis the primary focus is the cecum, appendix, or con- tiguous portions of the ileum and colon, i. e., in the right iliac fossa; from 10 to 15% of the cases in the rectum. In comparatively few cases has the primary focus occurred in the small intestine. There thus remain a certain number of cases in which the primary focus is undetermined, even though careful post-mortem examinations have been made. Grill has distinguished three typical periods in the course of abdominal actinomycosis:— 1. The initial period. 2. The period of tumor formation. 3. The period of fistula. To these three periods Hinglais has added a fourth—a period of repair. Although in certain cases this or that period mav predominate or be entirely absent, nevertheless, the periods mentioned are usually characteristic of the disease, when localized in the abdomen. Pain, while usually present, is rarely severe, being rather a sensation of tension and discomfort. In rectal actinomycosis the fistulae usually open