Some remote effects of appendicitis ; Two cases of papilloma of rectum treated by excision of mucous membrane / by T. Kennedy Dalziel, M.B., C.M., F.F.P.S., [Assistant Surgeon, Western Infirmary ; Surgeon, Royal Hospital for Sick Children].

  • Dalziel, T. Kennedy.
Date:
[1897?]
Catalogue details

Licence: Public Domain Mark

Credit: Some remote effects of appendicitis ; Two cases of papilloma of rectum treated by excision of mucous membrane / by T. Kennedy Dalziel, M.B., C.M., F.F.P.S., [Assistant Surgeon, Western Infirmary ; Surgeon, Royal Hospital for Sick Children]. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    4/10 (page 2)
    the cases have a special bearing on the position of the omentum, it may be well to bear in mind that, especially in early life, the omentum may extend to the brim of the pelvis, and naturally come in more intimate contact with the then pro- minent appendix than in later life, when both structures shrink—the omentum being drawn upwards, and the appendix frequently displaced so that it may lie behind the caecum or elsewhere. Under ten years of age the omentum and appendix, as a rule, seem to be in contact or within reach of adhesion from a mild degree of plastic inflammation. Should such an adhesion take place, the symptoms in the early stage seem to be those of slight gastric disturbance, becoming more severe as the adhesion becomes more intimate, and fibrous contraction of the omentum sets in. The ultimate condition is, that the web-like omentum shrinks and gathers itself into a firm band of tissue extending from the transverse colon to the right iliac fossa. In several of such cases which have come under my observation secondary adhesions have formed between the surface of this contracted omentum and the anterior abdominal wall, especially in the neighbourhood of the umbilicus. Such a band gives rise to great risk of strangulation or to persistent colic, especi- ally marked—as is usual where adhesions implicate the colon— before defaecation occurs. As a rule the pain is described as of a dragging character, and in one case it was noted that during acute spasms the umbilicus was distinctly drawn inwards. Vomiting, diarrhoea alternating with constipation, frequency of micturition, abdominal distention from accumulation of flatus, may occur at one time or another, and induce such a condition as more than warrants abdominal section. CASE 1. A. B., a patient of Dr. Gemmell’s of Airdrie, came under my care in August, 1892, suffering from acute intestinal obstruc- tion. In 24 hours spontaneous relief was obtained, and he remained well for ten days. He again suffered from acute