Primary malignant disease of the vermiform appendix.

  • Rolleston, Humphry Davy, 1862-1944.
Date:
1906
Catalogue details

Licence: In copyright

Credit: Primary malignant disease of the vermiform appendix. 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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    attention lias evidently been focussed on tlie existence of tlic growth to the exclusion of any other less striking or less important feature. Acute inflammation was found in 13 cases. Obliterating appendicitis was mentioned in 11, in 3 of which the growth was described as arising at the stricture, but it is possible that the stricture in some of the other 8 cases was due entirely to the growth, as it was stated to be in discard's case (26), in which there was pus in the distal portion of the appendix and an abscess in the right iliac fossa. Catarrhal appendicitis (Norris), chronic appendicitis with ulceration (Walsliam), and chronic inflammation (A. 0. J. Kelly) are mentioned in 1 case each. Adhesions were stated to be present in 15 cases. In 2 cases, Beger and Biting (Case 30, vide List, p. 148), there was a fistula of three and a half years and six months duration respectively. The growth may, as already pointed out, produce a stricture; further, by projecting into the lumen it may completely obliterate the lumen, even (as in Case 42) in microscopic sections. A concretion was mentioned as being present in only three cases (Letulle and Weinberg [Case 10], Walsliam, and Hurdon). This is a striking contrast to the frequent asso- ciations of calculi and primary carcinoma of the gall-bladder. The average length of the normal appendix is about 8 or 9 cm. (Lockwood (46)). In the case of primary malig- nant disease the average length of the recorded cases was found to be 7*4 cm. Secondary Growths. In only 5 of the 42 cases, or 12 per cent., were secondary growths described as being present; in 3 cases (Fiske- Jones and Simmonds, Beger, and A. 0. J. Kelly [Case 16]), the abdominal lymphatic glands were involved, in 2 cases (A. 0. J. Kelly [Case 16] and Biting [Case 30]) there were