Case of excision of the rectum : with a note on the operation of inguinal colotomy / by F.T. Paul.

  • Paul, F. T. (Frank Thomas), 1851-1941.
Date:
[1891]
Catalogue details

Licence: Public Domain Mark

Credit: Case of excision of the rectum : with a note on the operation of inguinal colotomy / by F.T. Paul. 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.

    6/7 (page 465)
    more comfortable. Blood ceased to come, but mucus was often passed. On March 24, just three weeks after doing the colo- tomy, I excised the rectum, following the steps recommended by Dr Alexander.1 I met with no difficulty, except that it was necessary to open the peritoneum, and that a little hardness, probably malignant, was left attached to the right ureter in preference to injuring that structure. There was no difficulty in controlling the haemorrhage. The amount of bowel removed was not accurately measured, but would be about 6 or 7 inches. The wound left by this operation is enormous, but it appears to heal well, the two sides falling together, and uniting much quicker than would be expected. He left the Infirmary on June 4, six weeks after the operation. I know that he is still living at Wrexham, but have not been able to obtain any details as to his condition of health and comfort.2 The second case was that of a woman in the Royal Infirmary left me by my colleague, Mr Banks, when he went for his sum- mer holiday. It was one of obstruction of the bowels, and he considered that some operation to give relief should be per- formed without much delay. Her age was 37, and she was the mother of nine healthy children. There was no history of syphilis, and none indicating previous ulceration of the bowel. She always had been troubled with constipation, and during the past twelve months this difficulty had greatly increased. She was often attacked with colic, and could feel the bowels gather up into lumps in the front of her stomach. From August 4 to 7 she suffered from almost complete obstruction, and vomited the medicine given to relieve her. On August 8 she was admitted. On examining the rectum with the finger, about 2^- inches from the orifice was a large hard mass, infiltrating and sur- rounding the bowel, and tightly constricting it. The lump was as large as a medium orange. It had not destroyed the 1 Liverpool Mcclico-Chirurgical Journal, July 1887, page 1. 2 He subsequently returned to the Infirmary, and died from local recurrence, complicated with septic infection of the peritoneum due to necrosis of the cut end of the sacrum.