On gastro-colic fistula : a collection of cases and observations on its pathology, diagnosis, etc. / by Charles Murchison, M.D.

  • Murchison, Charles, 1830-1879.
Date:
[1857]
Catalogue details

Licence: Public Domain Mark

Credit: On gastro-colic fistula : a collection of cases and observations on its pathology, diagnosis, etc. / by Charles Murchison, M.D. Source: Wellcome Collection.

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

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    lysis came on, along with pain and oppression after meals, and a feeling as if food would not pass down. On admission, antemia; losing flesh; complexion dusky; pain after food October 6.— For several days has complained of severe headache, with pain in epigastrium and sickness, and during the last two, and throughout to-day, especially after meals, has several times vomited a considerable quantity of yel- low matter, having the odour and appearance of rather relaxed feces. Pain after eating; borborygmi; flatulence; tenderness at epigastrium, where a firm- ness can be felt on pressure; increasing anaemia and emaciation. After taking four grains of calomel had several motions, and vomited about same quantity of feces as that passed per amom. October 10.—Vomited fecal matter on evening of 8th, and not since ; but has, on several occasions, complained of fecal odour of breath, and taste at times intolerable; bowels freely open. A splashing sound heard on percussion, espe- cially on right side of abdomen. October 11.—Left leg much swollen and painful, so as to prevent sleep; great thirst and craving hunger. October 15.—Much hiccup; vomiting of feces mixed with undigested food; appetite gone; bowels freely open; motions of same characters as vomited matter. Continued to sink, and died on October 26, three weeks from commencement of fecal vomiting. For the last week, vomited everything he swallowed. A gastro-colic fistula was diagnosed during life. Great emaciation. Great omentxmi puckered, and incorporated with stomach and arch of colon, where they were in contact. On tearing it Post-Mortem- up, an enormous opening into anterior wall of stomach, near pyloric end, and into transverse colon, at once exposed. About 4 inches of the colon were thus destroyed, and an inch in centre of this space so completely, that nothing but the longitudinal muscular band remained. The opening in stomach corresponded with this, as far as it went, the two being ag- glutinated by adherent omentum. But aperture in stomach extended an inch and a half farther, to within an inch of pylorus, this portion being closed up by omentum. Ulcerated edges of both stomach and colon dark, very jagged and thickened, but not hard. Stomach and intestines elsewhere healthy. Some feculent matter in stomach. XXX. Dr Baklow. Manual of Practice of Medicine, 1856, p. 422. Fur- ther particulars furnished in private letter. An elderly man became a patient of Dr B.'s at the Surrey Dispensary, about 1836. Had been long suff^ering from apparently intractable History- dyspepsia, with great pain and distension, immediately after taking food. Had occasional, but not urgent, vomiting; and Dr B. now cannot positively say that it was not fecal. Several perforating ulcers were found in the stomach. Most of these had opened into the portions of intestine, between which and the Post-Mortem. stomach adhesion had been established before the perforation occurred. Thus, one communicated with duodenum, and two with transverse colon, whilst one opened freely into a large sac or pouch, formed by thick fibrinous lymph eff^used upon the surfaces of the adjacent viscera. One of the openings into colon was situated at middle of great curvature, and mea- sured a third of an inch in diameter ; the other, nearer the fundus, just admitted a probe. The opening into third portion of duodenum was situated near pylorus. No constriction of pylorus.