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.

    28/92 (page 28)
    to liave l)P«oi an instance of tin* disease under con- sideration. The ca.se reiiort(*d l)v Huber*■* must be excluded from those of hemorrhagic ]»ancreatitis. His j)ar tient died within twenty-tbnr hour.s after the onset of an attack of severe, ejiigastric pain. Theie was a tumor of the head f)f the pancreas surrounding the common duct, which was ])assable. 'I'he tumor de.scended into the mesentery. It looked like Fiirst(*r’s caicinoma simjdex, but had many pigmen- ted and hemorrhagic spots. 'i'he case of ]»ancre:itie hemorrhage rejiorted by Chalhind and Ifabow*® is also not wliolly clear with reference to its relation to ])ancreatitis. 'I'he patient, sixty-two years of age, an insane woman and inmate of an a.sylum, hail an ov'arian cystoma for several years. She wuis found, at bedtime, jiale and groaning feebly, without known cause. 'Die next day she was (‘(dlapsed. She complained of suffering, espe- cially in the lumbar and epiga.stric regions. 'I'he ]»ain was not increasi'd on jiressure and there w'as repeated vomiting. She remained in a condition of extreme weakness, with frequent vomiting and groaning, a quick jmlse and a subnormal temjiera- ture, till her death oji the fourteenth day. 'I'he jiancreas apjieared doubled in size. On tearing its tissue a certain quantity of thick, black blood esca])pd. In making a longitudinal section a cavity as large as the tist was opened, tilled with large, black clots, 'i'he ])ancreatic tissue was dark brown, and so softened and friable that it was impossible to determine the ])oint of origin of the hemorrhage. The duct was moderately dilated and the tissues in the immediate vicinity of the gland were strongly discolored with blood. 'I'his case is not included among those of hemor- rhagic jiancreatitis, since the described appearances do not correspond with those usually found and the possibility (d' a pancreatic cyst or of an aneurism is not eliminated. 5< Doutsoliex Arrh. ('.kiln. Moil., 1875, w. 4;Vi