On gastro-colic fistula : a collection of cases and observations on its pathology, diagnosis, etc. / by Charles Murchison.

  • Charles Murchison
Date:
1857
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Licence: Public Domain Mark

Credit: On gastro-colic fistula : a collection of cases and observations on its pathology, diagnosis, etc. / by Charles Murchison. 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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    The colon was firmly adlierent to stomach. In the great curvature of tlic latter, was an opening into the colon, as large as the palm of the Post-Mortem. hand. This opening was divided into two by a slip of the mucous membrane of the stomach, in such a way, that each half corre- sponded to one of the two ends of the divided colon, which could only communi- cate with one another through the stomach.^ IX. Dr Gintrac. Journal de Medecine de Boiirdeaux, July 1842; copied into Schmidt's Jahrbticher, vol. xl., 1843, p. 31. A man, jet. 57, had previously enjoyed good health. Two years before death, digestion became slow and difficult, being accompanied often by History. fetid eructations and vomiting. These symptoms increased, and profuse diarrhoea was superadded. Pain at epigastrium, but no tumour. Remarkable emaciation; pale, yellow countenance; small, frequent pulse ; dry tongue; complete loss of appetite; gradual sinking; death. At middle of great curvature of stomach an oval opening, ] i inch in diameter, connected with a similar opening in corresponding part of traus- Post-Mortem, verse colon. The margins of both these perforations were inti- mately connected with one another by a thick, reddish, old mem- brane. Pylorus normal. Mucous membrane near cardia thickened, with small rounded vegetations. In lesser curvature, a large, roimded, firm whitish tumour, presenting a scirrhous structure. The mucous membrane of the stomach was covered with a yellow fluid, which was also found in the colon. X. Dr Waters of Frederick Town, U. S. Philadelphia Medical Examiner, April 1845 ; Edin. Med. and Surg. Journal, vol. Ix., p. .237; Edin. Monthly Journal, v. 853 ; Vicrteljahrschrijt fiir die praMische, etc., vol. xii.. Sup. p. 53. A man, set. 66. In July 1843, attacked with severe dyspeptic symptoms, which persisted. On Jan. 10, 1844, had hsematemesis, followed by History. severe colic and meltena. Hsematemesis recurred at intervals for some weeks, always with pain. Once vomited puriform matter; hsematemesis ceased, but no improvement. Emaciation; lemon-yellow counte- nance ; marasmus j and death, nineteen months from commencement of illness. Pyloric extremity of stomach adhered to liver and arch of colon. A mass of cancer at pylorus, more than one inch thick, with an ulcerated Post-Mortem. surface. Between pylorus and colon an aperture, about half an inch in diameter, which allowed the contents of the stomach to pass into the colon. Mesenteric glands enlarged and indurated. XI. Mr Wiiitbourn. Lond. Med. Gazette, May 2,1845, p. 31; Edin. Med. and Surg. Journal, vol. Ixv., p. 238 ; Vierteljahrschrift fiir die praktische, etc., vol. xii., Sup. p. 53. A widow, £et. 64, admitted into Guy's Hospital, Nov. 6, 1844. For five years before admission, had a protrusion at the umbilicus, and History. for one year had been troubled with constipation and occasional abdominal tenderness. Soon after admission, the tumour at the umbilicus became hard and painful, and suppurated, discharging an unhealthy purulent matter, mixed with blood. The hardness was then observed to extend towards the left hypochondrium. On Nov. 17th, she had bilious vomiting, with obstinate constipation. On the I9th, bowels reUeved with pain, and passage of shreds of disorganized mucous membrane. From the 20tli to 21st, she vomited ' Although fetid eructations are noted, no mention is made of the odour of the vomited matter in this case; yet, from the anatomical distribution of the parts, it seems impossible that these did not contain feces.—C. M.