Acute intestinal obstruction caused by the ileum becoming adherent to a lithopedion / by J.H. Bryant.

  • Bryant, John Henry.
Date:
[1899?]
Catalogue details

Licence: Public Domain Mark

Credit: Acute intestinal obstruction caused by the ileum becoming adherent to a lithopedion / by J.H. Bryant. 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.

    6/12 (page 210)
    On November 29th she looked worse, and her eyes were sunken. Pulse 108, respiration 25, temperature 96-2°. A vaginal examina- tion was made and the cervix was found to be anteverted. On bimanual examination, a large, undefined, hard mass could be made out in the hypogastric and lower umbilical region, which appeared to be fixed to the uterus. Dr. Perry and Mr. Dunn saw her and an exploratory operation was decided on in order to determine, and if possible to remove, the cause of the obstruc- tion. Mr. Dunn made an incision in the median-line of the abdomen about five inches in length and commencing three inches above the umbilicus. On opening the peritoneal cavity the transverse colon was found to be collapsed. He explored the abdomen with the hand and found a very hard stony-like mass just above the pubes. It was considered to be a growth binding down and kinking some coils of small intestine. Owing to tbe extremely serious condition of the patient it was thought inadvisable to attempt to remove the hard mass, and so a portion of the small intestine, which was found to be very distended, was pulled out, and a Paul’s tube was inserted as near to the obstruction as possible. The abdomen was then closed, a small portion of the intestine containing the Paul’s tube being brought out of the lower part of the wound. She took the anaesthetic badly, and was very collapsed after- wards. She did not rally after the operation, and gradually sank and died at 4 a.m. I performed the necropsy ten hours after death. There were no signs of decomposition. Eigor mortis was well marked. There was an incision about five inches in length in the median line of the abdomen commencing three inches above tbe umbilicus, the upper portion of which had been united by gut sutures. A piece of small intestine in which was situated a Paul’s tube occupied the lower part of the incision. The lungs and pleurae were normal. The heart weighed 234 grammes, and was normal in appearance. The mouth, pharynx, oesophagus and stomach were normal. On opening the peritoneal cavity the hard mass felt during the opera- tion proved to be a, lithopedion; it wa,s situated in the mediap