The surgical diseases and injuries of the stomach and intestines / by F. Bowreman Jessettt.

  • Jessett, F. Bowreman (Frederic Bowreman)
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: The surgical diseases and injuries of the stomach and intestines / by F. Bowreman Jessettt. 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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    are situated on the anterior surface, but on account of their comparative infrequency, perforation occurs oftener in other situations. In 220 cases, Brinton states the posterior wall is affected in about 40 per cent. Eokit- ansky states that the ulcer is almost always situated near the lesser curvature. Surgically this is of very great importance, as intra- peritoneal abscesses may, and occasionally are, the result of perforation of a gastric ulcer into the lesser peritoneal cavity; or when adhesions have taken place between the ulcer and the adjacent surfaces of the pancreas or the liver, abscess may result, the pus usually collecting beneath the diaphragm forming the abscessus sub-phrenic2is of Leyden and others. This may burst into the pleural cavity, or the lung, or even the pericardium, many examples being recorded of such lesion. Mr. John W. Taylor has recorded two such cases,* and has collected brief notes of twenty-one others, all of which terminated fatally, and also ten in which the patients are reported to have recovered from perforation due to gastric ulcer. Two of these cases came under his own notice. In one of them he performed lapa- rotomy, letting out a large quantity of purulent fluid, and washing out the abdominal cavity and draining. The patient recovered from the operation, and some weeks afterwards, during some violent paroxysm of coughing, a considerable quantity of extremely foetid pus was expectorated. Mr. Taylor opened the chest five weeks after the first operation, and evacuated a large quantity of fetid pus, and drained the thorax. The patient im- proved considerably. She died shortly after from acute obstruction, which only had an indirect connection with her original illness. In the study of the treatment by surgical methods of * Birmiwiham Medicnl Record, April, 1888.