A case of sarcoma of the small intestine : with a note on the significance of 'rebound pain' in certain abdominal inflammatory conditions / by J.M. Elder.

  • Elder, John Munro, 1859-
Date:
1904
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Licence: In copyright

Credit: A case of sarcoma of the small intestine : with a note on the significance of 'rebound pain' in certain abdominal inflammatory conditions / by J.M. Elder. 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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    NOTE ON THE SIGNIFICANCE OF “REBOUND PAIN” IN CERTAIN ABDOMINAL INFLAMMATORY CONDITIONS. By J. M. ELDER, M. D. Surgeon to the Montreal General Hospital, Assistant Professor of Surgery, McGill University. Case Report. H. N.} Aet. 30, admitted about noon, July 30th, 1903 Complaints. Pains in the stomach. Present Illness. Two days before admission, patient felt a slight pain in his abdomen associated with general malaise, but remained at work and took his meals as usual. His bowels moved and he noticed some tenesmus and slight nausea after stool, but no vomiting. The following day he was obliged to stop work and took to bed. The pain had increased but there was no vomiting. Had another stool, which was quite painful. On the morning of the day of admission he had very acute pain at stool, and also on trying to pass urine. He felt somewhat feverish and called in a physician who sent him to the Montreal General Hospital, where he came under my care in Ward “ L.” Examination on Adiaission. Patient is a young man, fairly well nourished. Face somewhat pale, expression anxious, mucous membranes show moderate anaemia. Tongue lightly coated with whitish fur. Complains of pain across the lower part of his abdomen. T. 102°, P. 92, R. 24. Abdomen x-ather full, symmetrical, not moving much v ith respir- ation. On palpation there is acute tenderness and resistance over the whole of the lower zone, more marked on the right side. In the upper zone there is not much tenderness or muscular resistance. The “ rebound pain ” sign was very well marked. (See note.) There was evidence of some distension of the bladder, giving dulness for about one inch above the symphysis pubis. Rectal Examination showed an acutely tender mass, high up on the right side of the pelvis. Urine was drawn off and supra-pubic dulness disappeared. No mass was palpable through the abdominal wall, even under ether anaesthesia. Urinary examination gave negative findings. East History. Patient stated that he had suffered from recurrent attacks of al dominal pain for ten years, severe enough to keep him away from work for a few days each time.