Surgery.

Date:: [1913]

Catalogue details

Licence: In copyright

Credit: Surgery. Source: Wellcome Collection.

176/412 (page 148)

Describe Chronic Serous Peritonitis. When diffuse, this form is known as tuberculous ascites. It is commoner than the encysted variety. In addition to the ascites, enlarged mesenteric glands are found. They can be frequently palpated through the anterior abdominal wall. Distension of the abdomen, with dilatation of the superficial veins is a marked sign. The child is emaciated, and suffers from fever of a hectic type. Treatment is by general measures and should be carried out in a sanatorium. There is no indication for surgery unless complications occur. Describe Purulent Tuberculous Peritonitis. The purulent form was formerly called “ cold abscess of the belly.” It is most commonly found in young females, secondary to salpingitis. The progress of the disease is more rapid than that of the serous variety, and the hectic fever more pronounced. The fluid in the peritoneal cavity looks like pea-soup. Laparotomy should be carried out as early as possible and the affected tube removed. Describe Dry Tuberculous Peritonitis. This variety results in the formation of adhesions, which cause the omentum and viscera to become matted together. Very little fluid is poured out, and therefore the abdomen is only slightly distended ; on percussion, patches of dulness are found. These areas when palpated have a doughy feeling. The prognosis in dry tuberculous peritonitis is very grave, and surgical intervention is only called for in the presence of obstruction when the adhesions render operation a formid- able procedure. Describe Ascites. Ascites is a collection of serous fluid in the peritoneal cavity. The main causes are : (a) hepatic cirrhosis, (b) tuberculous peritonitis, (c) malignant disease of the peri- toneum, (d) cardiac disease, and (e) renal disease.