The significance of pain in the right iliac fossa in young women.

  • Winslow, Randolph (Professor)
Date:
1914
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Licence: In copyright

Credit: The significance of pain in the right iliac fossa in young women. 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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    tosis, or a general splanchnoptosis, is often the cause of the neurosis and of the pain in the right side. In cases of right sided pain without urgent symptoms, it would be well to till the colon with bismuth solution and skiagraph the large in- testine, before subjecting the patient to an operation. Of course, there may be disease of the appendix coincident with enteroptosis and probably in consequence of this condition; as is the case also with nephroptosis. It is probable that useful information could be obtained in cases of appendicular disease by skiagraphy, more frequently than is supposed, and I have recently seen an X-ray plate that showed clearly a distended appendix, after a bismuth enema. The X-ray findings in this case were verified by operation. In cases of pain in the right iliac fossa in a young woman or girl, without urgent symptoms, one should always bear in mind the possibility of an enteroptosis and make a careful examination for this condition. A displaced kidney may also cause pain and other symptoms strongly resembling those of appendicitis, but without elevation of temperature. The kidney can usually he palpated, especially if the patient is placed under an anaesthetic. It must not be forgotten that nephroptosis and disease of the appendix are often associated. The close relation of the female reproductive organs with the other viscera is also a potent cause of various reflex phenomena not referred to the pelvis. This is especially true in regard to pain referred to the right side. An acute salpingo-ovaritis may present the symptoms characteristic of acute appendicitis or the two may be associated. Indeed in certain classes of women it will be safer to suspect tubal disease rather than appendical, until a careful vaginal examination shows the pelvic organs not to be at fault. In the more chronic conditions of pain, and tenderness in the right side without muscular rigidity, elevation of temperature or leucocytosis, one should suspect other organs rather than the appendix. 1 have operated seven times on young women for supposed appendi- citis and have found small ovarian tumors on the right side