An account of a case in which recovery took place after laparotomy had been performed for septic peritonitis due to a perforation of the vermiform appendix : with remarks upon this and allied diseases / by Henry B. Sands.

  • Sands, Henry B. (Henry Berton), 1830-1888.
Date:
[1888]
Catalogue details

Licence: Public Domain Mark

Credit: An account of a case in which recovery took place after laparotomy had been performed for septic peritonitis due to a perforation of the vermiform appendix : with remarks upon this and allied diseases / by Henry B. Sands. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    case is also reported iu which there existed a perforation of the caecum. This was also unrecognized during life. In the remaining five cases the diseased appendix was found and removed at the time of operation. All the patients died except Hall’s,* in whom, during an operation for a sup- posed strangulated hernia, the hernial sac was found to con- tain an appendix vermiformis which was the seat of a per- foration caused by tubercular disease. The appendix was tied and cut off, the peritoneal cavity was exposed freely by extending the incision upward, and then thoroughly cleansed. The wound was drained by a rubber tube and tilled with iodoform gauze, and the patient recovered. Hall’s manage- ment of this case was judicious and skillful', and he certainly rescued his patient’s life. But his discovery of the perforated appendix was accidental, and I am acquainted with no case like mine in which a perforative peritonitis, due to disease of the appendix, has been diagnosticated, and treated by laparotomy with a favorable result. I avail myself of the present opportunity to discuss the surgical treatment of certain inflammatory affections origi- nating in the right iliac fossa—namely, those which proceed from disease of the caecum or its appendix. The subject is one of growing importance, and the surgical treatment of the diseases mentioned has been greatly improved in recent times. Nevertheless, there are some current notions con- cerning their morbid anatomy and treatment which appear to me to be erroneous, and which I am anxious to correct. My studies in this direction began early, and antedate the time when Parker performed his well-known operation for perityphlitis in 1866. Before this was done I made, at his request, a number of dissections in order to ascertain how the caecum and appendix could be approached with the least danger of wounding the peritonaeum, and found, as would * “ N. Y. Med. Jour.,” vol. xliii, p. 662.