Some cases of abdominal cysts following injury / by Rickman John Godlee.

  • Godlee, Rickman John, Sir, 1849-1925.
Date:
[1887]
Catalogue details

Licence: Public Domain Mark

Credit: Some cases of abdominal cysts following injury / by Rickman John Godlee. 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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    and administered some medicine, after which vomiting took place and the patient was relieved. He was kept in bed and fed with spoon diet for four days, after which he was able to go out for a walk and in the following week he went to school. At the end of this week he vomited after eating some fresh pork, and from that time to November 28, about two months, he had occasional attacks of indefinite illness and gradually lost flesh. I saw him on November 28, and found him with a tempe- rature of 103° and felt, when he was under chloroform, a dis- tinct tumour in the left side of the upper part of the abdomen ; but when he was admitted into the ward this tumour could not be made out. The next day the temperature was normal. He was kept in the hospital for nine weeks, during the whole of which time the temperature was slightly raised, being generally a little below, sometimes a little above normal. The tumour, which was sometimes only detected with difficulty, gradually became more distinct, occupying the epigastric and the left hypochondriac regions; it extended to the middle line in front and downwards to an inch above the umbilicus. There was a resonant percussion note over it, and a curious, splashing sound was heard on sharply tapping it above. This was no doubt caused by the movements of the contents of the stomach, and as I was convinced that I could feel the transverse colon crossing the lower part of the cyst I did not think it safe to explore with the aspirator needle, and so the boy was sent home for a while. He never had any urinary symptoms and all his other functions were natural. There were no signs of tubercle. The weight remained stationary : about 3 st. 2 lbs. On August 24, 1886, he came back (eleven months after the accident). The tumour had much increased in size; it occupied the whole of the epigastric region and was mesial in position, reaching on each side to the cartilage of the eighth rib and below to the umbilicus. It was movable from side to side and descended during inspiration. The stomach was clearly above it and the transverse colon apparently crossed its lower part as before. The boy's general health was good. His temperature was normal. On August 25 I made an incision through the abdominal wall 3 inches long, the lower end of which was 1± inches from the umbilicus. There were no peritoneal adhesions. Omentum (probably great omentum) appeared in the wound and also a piece of a viscus, presumably flattened great intestine, but I