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

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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$“ Tlie ])ancreiis w;is so much enlarged that its head wfis a half hundVbreadth wide, nnu h infiltrated with blootl, veiy dense, its structure not recognizable, in consequence of the enlargement of the gland its shape w'as more globular than rouml. Kahnis the authority for the fifth case. The stomach was dilated *• almost to bursting,” and was filled with clotted bhxHl. “ lu the middle of the abdomen there projei-ted frt>m the alKlominal aorta a dense, scirrhous tumor as large ;is the fist. It wa.s intimately united totheaorboand socompre.ssed it that, when the aortii wa.s oj>eneti, the finger w<*uld not pas.s through the narrow‘**«.l wimil. The narro\ved portion wa.s immediately ls>low the origin of the cifiliac artery. On close examimition of the tumor with referenci‘ to its origin, the head of the jian- ereas was degenerated in thi.s scirrhous mass, while the left part of the gland wiis in a wholly healthy state.” The sixth cji.se” i.s frtuu Morgjigni.” “The jtan- crejis w’a.s unusually large, ;ind contained round, toler- ably large tumors of a density somewhat ajtproaching th:it of cartilage.” To these is lulded jinothcr {s>ssible cjise, from Lieutaud,** in which jifteran ju-ute attack of gastric pain, fever, vomiting, anxiety, and fretpicuit fainting ‘the piuicreas was found much enlarged, harb and scirrhous throughout. The left kidney was in a state of liquefaction.” The first cjise im\v have been one of mercurial pousoning, the s(*cond was one of, probable, malig- nant disease. 'I'he tljird and fourth are jjossibly of infijuued pancrejis, but the evidence is in- sufficient to clearly establi.sh the diagnosis. The fifth case may have been one of aneurism, while the hist two are more suggestive of malignant dis- ease than of acute, jiancreatic inflammation. The common symptora.s were deeji-seated pain near the stomach, jiroducing a peculiar anxmty, ..1*^ *^‘**“** dla^0«l», mst, ub« 1. op. cit., “ CJiUMii, Op. eW., 21Z. 1»« Mdlbiu ot citiu morb., lit, Kpat. *,\x. mrl. lo “ Hat. Ai>al. .Mwl., J7«7, l. <,U. 1021$