Some cases of gastric and intestinal perforation and the lessons they teach / by D'Arcy Power.

  • Power, D'Arcy, 1855-1941.
Date:
[1902]
Catalogue details

Licence: In copyright

Credit: Some cases of gastric and intestinal perforation and the lessons they teach / by D'Arcy Power. 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.

    1/20
    [Reprinted from St. Bartholomew’s Hospital Reports, Vol. XXXVIII.] * I . I fv*v-4 \: 3, *2. -4 . | ) CWSV Jl ^ some cases of ! Gastric and intestinal )N AND THE LESSONS THEY TEACH. BY D’ARCY POWER, F.R.C.S. Eng. Cases of acute perforation of the stomach and intestine are not of very frequent occurrence in general practice, but a surgeon to a large general hospital sees a sufficient number every year to make him think that they require somewhat greater attention than is devoted to them at the present time, more especially in connection with their diagnosis. Such cases of acute perforation are often difficult to re- cognise because they do not always offer the classical signs of a rigid and motionless abdomen with absence of liver dulness, and they are, therefore, too often allowed to drift on until evidence of acute peritonitis or the onset of frncal vomiting causes the surgeon to be sent for, when his services are useless. My own experience teaches me that sudden and severe abdominal pain with a tender abdomen and a rapid pulse require early abdominal exploration, and that the need for an operation is instant when the pulse rate increases from half-hour to half-hour, especially if the tenderness be limited to a single point in the abdomen. Neither the temperature nor the respiratory rhythm gives such satisfactory indications as the pulse and the local abdominal tenderness, and one is not justified in delaying an exploratory abdominal operation because the temperature is normal or because the abdomen is moving during respiration. It is of the utmost importance to sew up the perforation at the earliest possible moment, for it is only by this means that life can be saved in acute cases. Free and thorough drainage of the abdominal cavity seems to be of great importance in the after treatment of acute perfora- tion of the stomach and duodenum. In two cases of perforated gastric ulcer recovery took place after I had sewn up the