Recurring appendicitis : is excision of the appendix during a remission a justifiable operation? : if so, when and how? / by Charles B. Porter.

  • Porter, C. B. (Charles Burnham), 1840-1909.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: Recurring appendicitis : is excision of the appendix during a remission a justifiable operation? : if so, when and how? / by Charles B. Porter. 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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    carefully broken up. The appendix separated from its attachment ligated with silk, removed. Wound closed with silk sutures except at lower angle where it was packed with iodoform gauze so as to shut off the stump from the peritoneal cavity. Reactionary temperature 100° F. Soon fell to normal and re- mained so. Recovery. CASE OF DR. CLARICE AND MR. GREIG SMITH.8 Female, aged twenty-two. Previous excellent health. First attack very severe, colickj^ pain about the ab- domen, not localized. Nausea, slight diarrhoea, head- ache. She was pale, with sunken eyes and anxious expression; knees drawn up. The least movement gave pain ; respiration shallow ; abdomen distended, excessively tender, especially in umbilical region ; no- where any dulness nor ascites ; stools loose and dark in color; pulse 108, small and weak; temperature 101.5° ; convalescence very slow, covering mouths, and never complete. A second attack about five months after the first, similar to first, but pains were localized in the right iliac fossa. Convalescence protracted for weeks, when Mr. Greig Smith agreed with Dr. Clarke that operation was advisable. Incision two inches in length,*its lower extremity being at the level of the anterior iliac spine and about an inch further inward. The operation was com- plicated and difficult. Appendix so thickened that it seemed that it would have stood erect without support; appendix removed. Adhesions prevented the invagination of the stump, so the peritoneum was gathered together over the mucous membrane by a con- tinuous silk suture. The appendix contained dark, grumous fluid, with three bodies, which turned out to be orange pips covered with.fajces and mucus. The * London Lancet, May 3, 1890, p. 956.