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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    thf; following day. Delirium was present in three cases. A tym})anitic swelling of the abdomen was of no infrequent occurrence. It was usually general, or in the upper alMlomen, and was randy localized in the lower alslomen. In one case, thought to be of intestinal obstruction, a swollen, intestinal convolu- tion was to be felt in the right side. Sym])toms of collapse were almost invariably present, and usually directly preceded death. This occurred as follows; — On the 2inl day c. s>'*. Srd •• r. •• “ 4-th “ ;t “ “ rail •• 1 •• “ oth “ 1 “ It took place after a fenv or several days, each in one case. The diagnosis lay between intestinal obstruction, perforative }>eritonitis, and an irritant poison. The pancreas was found enlarged, either through- out or at one extremity, usually at the head. The gland was fretpiently tloubled in size, and might seem still larger when abundant fat-tissue was pres- ent. The eidargement has been compared to the size of a man’s arm. The gland was generally dense, sometimes friable, and has been noticed to be of diminished consistency. The existence of hemorrhage was usually sus- pected by the appearance of the surface, which is of various shades of red. On section, however, the color may be dark-red, reddish-brown, violet, red- dish-black, or even black. The modification in color may be uniformly distributed, or lie in patches, or in specks. The patches correspond with nod- ules which may project above the surface. These discolored patches may show white specks or streaks, and the red color may lie in the interlobular tissue of the pancreas. The color of the section may be affected by the presence of associated alterations, one of which is accidental, the other may be incidental. The former is due to an excessive quantity of fat-tissue in the pancreas, sometimes appearing to form nodules as