Acute pancreatitis : a consideration of pancreatic hemorrhage, hemorrhagic, suppurative, and gangrenous pancreatitis, and of disseminated fat-necrosis : the Middleton-Goldsmith lecture for 1889 / by Reginald H. Fitz.

  • Reginald Heber Fitz
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Acute pancreatitis : a consideration of pancreatic hemorrhage, hemorrhagic, suppurative, and gangrenous pancreatitis, and of disseminated fat-necrosis : the Middleton-Goldsmith lecture for 1889 / by Reginald H. Fitz. 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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    infiltration in the liiliis of tlie spleen and a venous liyperaemia of the solar plexus. The abdominal or- gans were strongly injected and the j)ancreas was f.atty degenerated. Tlie consideration of this series of cases shows that most of the individuals concerned were in their usual health at the time of the attjmk, or when last seen alive. They were invariably adults and usually beyond the age of forty, when the age was given. Some were conspicuously fat and strong, while a few Averc weak and thin. Although several were of intern i>erate habits, others were not so reported, and two were exemplary in this resi)ect. Two had complained of previous digestive dis- turbance, and one suffered from frecpient abdominal pain. One had received a kick in the abdomen a week before death. From the evidence here collected there is evidently nothing in sex, habits, condition, or exposure which will indicate the likelihood of j)ancreatic hemorrluige. The cases and data are insufficient in number and detail to permit an exfict clinical picture of this affection which shall be of especial value in a differential diagnosis. We learn that pain Avas an early symptom in nearly one-half of the cases; that it was usually severe, and might be intense, and Avas to be found in the abdomen or loAver chest. Although mention is made of its presence in the epigastrium in one- fifth of the cases, this region is not conspicuously designated as the seat. On the contrary, there may be little or no ])ain, or merely a sense of constric.- tion of the chest. Nausea or Ammiting is but occa- sionally mentioned; constipation or a desire for frequent stools are still more rarely noted. The most constant symptoms are those of collapse, and are more or less intense and more or less prolonged. Death may take place within a half-hour after the onset of the symptoms and may be delayed for thirty-six hours. It is questionable in the latter instance Avhether the case should not, more proj)- erly, be included under the head of hemorrhagic pancreatitis than of pancreatic hemorrhage.