Surgery.

Date:: [1913]

Credit: Surgery. Source: Wellcome Collection.

172/412 (page 144)

$bladder will spread into the urachus and cause an abscess. This abscess points at the umbilicus, and both pus and urine escape. Sometimes both the umbilical and vesical ex- tremities of the urachus close, and the intervening portion becomes cystic—urachal cysts. In the majority of cases they are extra-peritoneal in position. Such abnormal conditions of the urachus should be rectified by operation. Classify Peritonitis. Non-infective. Septic or infective <J Diffuse Localised f Acute. \ Chronic. f Acute. \ Chronic. Mention the Chief Causes of Peritonitis. (a) Intra-abdominal acute infections, e.g. appendicitis, diverticulitis, etc. (.b) Acute perforations of hollow viscera, e.g. duodenal ulcer. (c) Septicaemia, e.g. pneumococcal. (d) Vascular lesions of hollow viscera, e.g. volvulus, intussusception, strangulation. (e) Mesenteric vascular lesions, e.g. embolism or throm- bosis. (/) Penetrating injuries and intraperitoneal ruptures of viscera. (g) By ascending infection through the genital tract in the female. (h) Aseptic peritonitis due to escape of urine in intra- peritoneal rupture of the bladder, blood bile or pancreatic juice. May become secondarily infected. (i) Post-operative. What are the Common Organisms ? In peritonitis from a visceral lesion the organisms respons- ible are the normal inhabitants of the alimentary tract, e.g. bacillus coli, bacillus proteus and bacillus Welchii. Strepto- coccal infection is seen in puerperal infections; pneumococcal$

Surgery.

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