A case of associated streptococcus infection of the vermiform appendix and Fallopian tube / by Hunter Robb.

  • Robb, Hunter, 1863-1940.
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: A case of associated streptococcus infection of the vermiform appendix and Fallopian tube / by Hunter Robb. 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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    below 135. The morning of the fifth day it suddenly in- creased to 140 and remained between this and 130 until 10 A. M., when it again rose to 150 and afterwards to 180, when she died at 4 P. M. She was stimulated by hypodermics of strychnia and digi- talis; stimulants were also administered by the mouth and rectum. Her bowels were fairly well opened by salts and oil enemata on the third day. Autopsy made November 15, 1891, at 9 P. M., five hours after death.1 Anatomical diagnosis.—Intestinal hemorrhage, round ulcer of the duodenum, with erosion of small vein. Operation wound, removal of ovaries and tubes, amputation of appendix, localized peritonitis in pelvis and around stump of appendix; tape-worm in intestines. All the tissues are very anaemic. Body.—Large, strongly built, well nourished, no oedema, skin smooth, abundant fat in subcutaneous tissue, small amount of blood escapes on section. In anterior abdominal wall in the median line, commencing 4 cm. below navel, is an incision closed by sutures, the whole covered over tightly by a plaster sprinkled with iodoform. Edges of wound adhe- rent. A slight amount of bloody exudation in and around the edges. Subcutaneous tissue and muscle on either side of wound contain a small amount of hemorrhagic infiltration. On opening the abdominal cavity several loops of small intestines are distended and of a purplish color; the abdom- inal wound is slightly adherent to tissues beneath. The intestines are generally not adherent, but two or three loops of small intestine are lightly adherent in the pelvis. On sepa- rating these adhesions the adherent portions are covered by a slight hemorrhagic fibrinous exudation. The peritoneum is moist. In the pelvis, and partly shut in by adherent loops of intestine, there are about 50 cc. of hemorrhagic purulent fluid. Scattered over the intestine, especially over the most distended portions, there are a few very slight fibrinous flakes. A loop of the ileum is adherent at the end of the caecum, and shut in by this adherent loop and by its own mesentery and by the peritoneum is a small cavity about as large as the 1 From the Pathological Laboratory of the Johns Hopkins Hospital.