Habitual epigastric protrusion / Anthony Bassler.

  • Bassler, Anthony, 1874-
Date:
1911
Catalogue details

Licence: In copyright

Credit: Habitual epigastric protrusion / Anthony Bassler. 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.

    4/4
    4 now at times the condition came on involuntarily (even when he made an effort to control it) so that each day he would have a number of seizures. Two years ago he began suffering with headaches, constipation, and much belching of gas follow- ing the meals, coming on at once or up to fifteen minutes after- ward. During this time he has had more or less after-meal distress in the stomach, particularly when he partook heavily of sweets. He has increased appetite for foods; sleeps well; has gained considerably in weight during the last year. Examination.—Well-nourished boy of good muscular devel- opment. Heart, lungs, urine, blood, etc., normal. Marked splash in stomach, organ somewhat relaxed but not enlarged or ptosed. Left lobe of liver freely palpable and margin low, although right lobe could not be felt and upper border was in normal position. In repose, there was a slight transverse ful- ness in the upper abdomen which seemed to be due to the prominence of the left lobe of the liver and a general tissue condition. During the examination, a contraction came on. It began with a slight inspiration and a fixing of the dia- phragm in that position, followed by a contraction of the abdominal muscles below the transverse navel line without any noticeable bulging of the epigastrium. The patient then seemed to fix the lower abdominal muscles, slightly exhaled, and then took a deep inspiration, at which the descended dia- phragm working against the contracted abdomen below and an accompanying relaxation of the abdominal muscles above the transverse navel line caused the liver (left lobe) and a por- tion of the stomach to protrude forward and make up the pouch. The prominence of the liver when the abdomen was in repose was due to a twisting forward of the organ, which had become considerably set in that deformity from the constant malfor- mations of the organ during the seizures. Treatment.—The treatment advised was a cessation of the habit, an anticonstipation diet, and 5 drops of tincture of nux vomica, three times a day, to correct the slight degree of gastric atony. 120 East Sixtieth Street. Reprinted from The Journal of the American Medical Association Dec. 16, 1911, Vol. LVII, p. 1970 Copyright, 1911 American Medical Association, 535 Dearborn Ave., Chicago