Case of intestinal obstruction due to narrowing of the calibre of the bowel, as the result of recurring appendicitis / by T. Lauder Brunton and W. Watson Cheyne.

  • Brunton, Thomas Lauder, Sir, 1844-1916.
Date:
[1894]
Catalogue details

Licence: Public Domain Mark

Credit: Case of intestinal obstruction due to narrowing of the calibre of the bowel, as the result of recurring appendicitis / by T. Lauder Brunton and W. Watson Cheyne. 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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    Reprinted from Vol. XXVII of the ‘ Clinical Society’s Transactions Case of Intestinal Obstruction due to narrowing of the calibre of the bowel, as the result of recurring appen- dicitis. By T. Lauder Brunton, M.D., F.R.S., and W. Watson Cheyne, F.R.S. Bead April 27, 1894. THE patient was a gentleman aet. 35, who was first taken ill in May, 1892, with fever, pain in the right iliac fossa, and other symptoms which led to the diagnosis of appendicitis, but which subsided without surgical interference. Since that time he had had a number of similar attacks of varying inten- sity, five of them severe ones, the last one being in May, 1893, and lasting about fourteen days. He had during this time paid great attention to the regulation of his diet, living chiefly on soups, potted meat, bread and milk, &c. He had been seen at various times by Dr. Lauder Brunton, and also by a well- known surgeon, who had urged removal of the appendix, to which the patient would have submitted but that he did not feel able to spare the necessary time from his work. During last summer the patient remained pretty well, except that he was much troubled with obstinate constipation. On September 11 last he had a severe attack of griping pain, chiefly on the left side, which lasted nearly an hour and then passed off. These attacks continued to recur with increasing fre- quency, and the constipation, though not absolute, became more obstinate. He had no fever, and did not remain in bed. On the evening of September 22 he took a dose of castor oil, which did not act; on the contrary, the griping pains became very severe and almost constant, and he was completely obstructed, no flatus being passed. He had no vomiting. During the afternoon of September 23 he passed into a very collapsed state, the pain became intense, and Dr. Brunton was sent for. He advised that a surgeon should be called in with- out delay, and accordingly Mr. Watson Cheyne was asked to see him, and did so with Dr. Brunton at 10 p.m. His condition was then as follows :—Pulse 80, very small—in fact, hardly perceptible. Temp. 97'4°. Great pain, essentially of a griping character, starting on the left side and running towards the umbilicus; no tenderness anywhere, not much distension,