Case of strangulated hernia, with perforation of the bowel : in which the occlusion of the aperture by ligature was successfully adopted / by Patrick Henry Watson.

  • Watson, Patrick Heron, 1832-1907.
Date:
1869
Catalogue details

Licence: Public Domain Mark

Credit: Case of strangulated hernia, with perforation of the bowel : in which the occlusion of the aperture by ligature was successfully adopted / by Patrick Henry Watson. 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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    CASE OF STRANGULATED HERNIA. On Monday the 22d Febraaiy, Dr Littlejohn received a telegram from Dr Bell of Kettle, in Fife, summoning him to his relative Miss W., and requesting him to bring me along with him, to operate upon her for a strangulated hernia. On reaching our destination about midday, we found the patient, an active woman of spare habit, but upwards of sixty years of age, in a state of prostration bordering on collapse. The abdomen was tense and tender, the pulse still hard in stroke, becoming frequent in number, but small in volume, constant hiccough and vomiting, a flushed face, a dry tongue, a feeble whispering voice, and copious general diaphoresis. The hernial tumour which occupied the right femoral space was ovoid, lying along the line of Poupart’s ligament, tense and tender to touch, the surface slightly reddened, and the cu- taneous textures agglutinated to the parts beneath. Her history was one of old reducible hernia, for which she never wore a truss. She stated that when in Kettle, seventy-two hours previous to our visit, she felt the rupture start in her groin, occasioning pain and a sense of faint- ness ; that she returned home immediately, and attempted to reduce the swelling, but without effect; that about 9 P.M. vomiting set in, and that ever since she had suffered from intense twisting anguish in the region of the umbilicus, with constant retching, and latterly hiccough. To relieve these symptoms she had taken aperient medi- cine, which had been ejected by vomiting, and had applied warm fomentations to the belly. It was not until seven hours before the period of our visit that Miss W. sent for Dr Bell, who at once, on ex- amining her, telegraphed to Edinburgh for Dr Littlejohn and myself. The condition of matters rendered an immediate recourse to opera- tion imperative. Accordingly, having administered chloroform, I proceeded, with the assistance of Drs Littlejohn and Bell, to operate in the usual manner. On opening the sac, a quantity of claret- coloured muddy fluid escaped, and on exposing the contents, whicli consisted only of bowel, and sponging its surface, we found it pre- sented a dark-chocolate colour, with its glistening serous surface