Case of acute diffuse suppurative peritonitis successfully treated by laparotomy and drainage, but without irrigation / by G.A. Hawkins-Ambler and R. Lawford Knaggs.

  • Hawkins-Ambler, G. A. (George Arthur)
Date:
[1890]
Catalogue details

Licence: Public Domain Mark

Credit: Case of acute diffuse suppurative peritonitis successfully treated by laparotomy and drainage, but without irrigation / by G.A. Hawkins-Ambler and R. Lawford Knaggs. 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.

    5/15
    Reprinted from Vol. XXIII of the ' Clinical Society’s Transactions.’’] Case of Acute Diffuse Suppurative Peritonitis suc- cessfuUn treated by laparotomy and drainage, hut without irrigation. By Gr. A. Hawkins-Ambler and K. Lawford Knaggs. Bead April 11, 1890. rpHE patient, a boy set. 9, with clubbed fingers and a Jl phthisical family history, but no evident disease in the chest, had complained for some weeks of griping pains in the abdomen. These he attributed to a kick by a playmate a year before in the lower part of the stomach. On May 19, 1889, the boy was taken worse with uneasy feelings in the lower part of the abdomen, and vomited his food. The vomiting continued on the following days, and on the *22nd My. Hawkins-Ambler found him complaining of griping pains, the abdomen being slightly tender to pressure. He was sent to bed and ordered a rhubarb and soda mixture with a liquid diet. The symptoms seemed relieved on the 23rd, and on the 24th his grandmother treated him to a large slice'of Yorkshire pudding. After this, intermittent abdo- minal pains came on and increased in severity. On the morning of the 25th a small slimy motion was passed—the first, as far as could be gathered, since the 19th, —and in the afternoon he was lying in bed with knees drawn up, a pulse of 120, and temp. 101’2°. The abdomen was tender, resonant all over, but not tym- panitic. The chief complaint was of recurring attacks of pain in the stomach, which passed off and left him perfectly easy. Opium was prescribed. On the 26th the abdomen began to swell and became tympanitic, and slight vomiting (green) returned. The bowels were not moved and no fiatus passed, but the pains were easier. He was seen at 10 p.m. in consultation with Mr. LaAvford Knaggs. There was then a tympanitic and much- distended abdomen. It was resonant all over and the recti were rigid. It did not move in respiration. No tumour could be felt, but palpation was painful and gave rise to peristalsis, visible through the abdominal wall, and causing the child to become restive and cry. The legs were drawn up. The tongue was moist, the lips dry, and thirst great. Pulse 120, temp, normal.