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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    In three of the operations a portion of the caecum sur- rounding the base of the appendix was excised with the latter organ (Fiske-Jones and Simmonds, Paterson, Kelly and Hurdon, Case 39). In one case (Fiske-Jones and Simmonds) it was necessary to remove some glands in the mesentery. Beger operated for the relief of a persistent iliac fistula. Siting, operating for a similar condition, was forced to remove the caecum and part of the colon and ileum owing to the wide spread of the disease (Case 30), and the sar- coma in Warren's case was so extensive as to require a similar operation. Tice results, immediate and remote, of the operation, have been surprisingly good. There were four deaths within two weeks of the opera- tion. Beger's patient, who had had a fistula in the iliac region for three and a half years, did not survive the attempt to remove the condition. One case of Biting (Case 30), also with a fistula, in whom the operation consisted in the removal of a large amount of intestine, died two weeks later; one case (A. O. J. Kelly [Case 16, vide p. 145]), a man of 63, in whom the growth had formed secondary metastases, also died; and the fourth patient was Paterson's, in whom it was necessary to remove part of the caecum. In the majority of the other cases recovery is definitely stated to have occurred. The presence of the growth, unless it is so advanced as to require removal of some additional portion of the in- testinal tract, seems not to increase the risk of the operation of appendicectomy. Of the twenty-nine patients who made recoveries, one died four months later (Harte and Wilson, Case 24) after an operation to relieve obstruction caused by a band in the right iliac fossa, but post mortem there was no recurrence. None of the other patients—and some have been heard of years after the operation—can be found to present any suggestion of recurrence.