Clinical and pathological observations on acute abdominal diseases due to conditions of the alimentary tract and the uniformity of their origin : the Erasmus Wilson Lectures 1904 / by Edred M. Corner.

  • Corner, Edred M. (Edred Moss), 1872-
Date:
1904
Catalogue details

Licence: Public Domain Mark

Credit: Clinical and pathological observations on acute abdominal diseases due to conditions of the alimentary tract and the uniformity of their origin : the Erasmus Wilson Lectures 1904 / by Edred M. Corner. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    stricture is so tight that in the production of the strangula- tion both arteries and veins may be almost or even com- pletely and simultaneously occluded. Two things result from this : Firstly, the sac almost invariably contains little or no fluid, and secondly, the gut is not oedematous or doughy, as is taught. On the contrary, it is thin, inelastic, and does not recover its shape when deformed, as it easily is. Its surface may glisten as the empty condition of the vessels interferes with the inflammatory dulling or glazing of the peritoneum covering it. It contains blood if the initial vascular strangulation has been incomplete ; no gas is pre- sent within its lumen having been absorbed by the extravasated blood. There may be signs of local peritonitis on the sac rather than on the bowel, as evidenced by dulling, glazing, etc., or a perforation of the bowel maybe present. This necrosed bowel differs very markedly from that ordinarily described, on account of the different method of its production. The necrosis is the result of the combina- tion of tight strangulation and the subsequent action of microorganisms. The above described signs are evidences of the former factor almost entirely. Examples are given in the paper in the St. Thomas' Hospital Reports, 1900, pp.' 347-349, which illustrate the following clinical types— (1) A local infective peritonitis in the hernia sac without gangrene of the gut, due to the diapedesis of organisms through the wall. (2) A general infective peritonitis after the reposition of the bowel within the abdomen and without gangrene of the strangulated loop, also due to the diapedesis of organisms. (3) The occurrence of general peritonitis and gangrene of the strangulated loop after the return of apparently healthy bowel to the abdomen.