Descriptive catalogue of the specimens illustrating medical pathology, in the Museum of University College, London / Charles Stonham.

  • Stonham, Charles, 1858-1916.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Descriptive catalogue of the specimens illustrating medical pathology, in the Museum of University College, London / Charles Stonham. Source: Wellcome Collection.

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

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    3045. An ulcer of the stomach with an aneurysmal dilatation of a branch of the coronary artery, the aneurysm bursting into the floor of the ulcer. The ulcer is situated about two inches from the oesophageal opening, and just in front of the attachment of the small omentum. It is oval in shape, very small, and quite shallow, with a smooth floor; it is, in fact, the merest surface-lesion. At the larger end of the oval is a circular hole surrounded by a raised ring, which projects about yjj inch above the surface. This is the mouth of a short channel which pierces the wall of the stomach, and opens directly into one of the main branches of the coronary artery. The specimen must be regarded as one of aneurysmal dilatation in the floor of a gastric ulcer—a very rare condition. The aneurysm, which has burst, originated, ^vithout doubt, at a time when the ulceration was in active progress, and had led to the exposure and implication of the A^essels. A \veak spot in the arterial wall then gradually yielded under the distending force of the blood-pressure, and ulti- timately the sac ruptured. It is noticeable that the aneurysm, once started, progressed, although the ulceror- tion which caused it has all but healed. 4185 3046. -A- portion of a stomach, showing an ulcer situated in the lesser curvature about 1^ inches from the oesophagus. The ulcer is very deep, with sharply-cut abrupt edges, which are at one part much undermined. The floor is tolerably smooth, and is perforated at the upper part by an oval aperture with clean-cut edges (? artificial; there is very little history to the specimen, and in the MS. Catalogue no mention is made of this opening) ; to the right of this, and lower down, is a smaller opening, circular, and with smooth, somewhat raised borders; this cannot be directly traced into an ai'tery, but a branch of the coronary runs so very close to it, that a communication is probable, especially as the patient died from profuse hsematemesis. A bristle marks the course of the coronary artery. 2128 3047. The pyloric end of a stomach, showing an ulcer on the posterior wall. The ulcer measures f by of an inch in diameter. It is oval in shape, and deeply cut with smooth and overhanging margins. The floor is uneven, and the orifices of tb'ree arteries of considerable size open on the surface. The floor is formed by omental or mesenteric tissue, the walls of the stomach having been completely perforated. The main trunk of the artery, of which the eroded vessels are branches, has been dissected out. From its size, it must be one of the main branchings of the cceliac axis, probably the coronary. 1361 History.—The specimen is from a youth. There was precordial pain, with severe attacks of vomiting brought on by food, with occasional haBmatemesis, the blood being clotted. Death resulted from the repeated hcemorrhages. Besides the above conditions a small aneur'ysmal sac, the size of a pigeon's egg, was found in connection with the aorta. Its cavity was filled with blood-clot, and the neck, which was small, was covered with a fine membrane. During life the pulse was weak and fluttering, and the heart was thought to be diseased. The sac of the aneurysm was partly calcareous. It is probable that the cure of the aneurysm was in part, at least, dependent upon the diminished force of the blood-current produced by the repeated liseraatemesis. 3048. A. portion of a stomach, showing a gastric ulcer which has extended through the coats of two vessels. The ulcer is situated about 2h inches from the pylorus; it is oval in shape, and measures 1 inch by | inch. It is quite shallow, with clean-cut edges and smooth floor. Bristles have been passed into the orifices of two large vessels, opeuiug on the floor. Posteriorly, these eroded vessels have been dissected out, and are seen to be large arterial branches, probably from the coronary. 2409 3049. A portion of the stomach, showing extensive superficial ulceration of the mucous membrane, most marked in the middle and along the lesser curvature, where it reaches nearly to the oesophagus. In the middle there is also some deep