On the causes of death after lithotomy / by Thomas Bryant.

  • Bryant, Thomas, 1828-1914.
Date:
[1857]
Catalogue details

Licence: Public Domain Mark

Credit: On the causes of death after lithotomy / by Thomas Bryant. 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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    Avliicli I have now collected would not appear to confirm this general opinion^ hut to suggest that pelvic cellulitis, although a fatal complication, is one that for the most part arises with- out urinary infiltration, as a result of continuity of a struc- ture which has become inflamed from the necessary injury inflicted upon it by the operation, or by the presence of a calculus. In the following cases such an opinion seems to be sup- ported, as also in others associated with other complications. Under this head of pelvic cellulitis as a cause of death are numbered six cases, or 15 per cent. Case xviii.—A healthy child, set. 6, having had an oxalate of lime calculus removed by lithotomy, without the slightest difficulty, appeared to progress favorably till the noon of the following day, when pain and tenderness of the hypogastric region made their appearance. On the second day symptoms of severe prostration came on, which proved fatal at night, or forty-eight hours after the operation. Post-mortem.—In the pelvis the peritoneum was somewhat injected, and in parts glued feebly together, more especially at its sides. The cellular tissue subjacent to the peritaneum in the anterior part of the pubic region was infiltrated with sanguinolent, but not puriform fluid; and posteriorly, inferiorly, and laterally was softened and easily broke down, and was in parts infiltrated with sanious, sero-purulent fluid; this infiltra- tion of cellular tissue extended upwards towards the kidneys. Mucous membrane of bladder slightly red, but appeared other- wise healthy. Kidneys and other viscera were healthy. The incision through the prostate was limited.' Case xix.—A boy, set. 15, gradually sank after lithotomy. The bladder appeared bruised on its inner surface, and its coats thickened. The pelvis contained much pus, which had passed through an opening in the peritoneum which com- municated with an abscess between the fundus of the bladder and the peritoneum. The intestines at this part were adhe- rent to each other. Viscera and other parts were healthy. Case xx.—A boy, set. 14, having had symptoms of stone