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 ... This and Allied Diseases (Classic Reprint) - Hardcover

Inhaltsangabe

Excerpt from 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

December sum - s temperature, pulse, 130; respiration, 30. Has taken five ounces of beef~tea and two ounces and a half of milk, as there was neither nausea nor vomiting. Local tenderness not lessened, tympanites increased. Decided dullness on percussion over iliac region. Although there had been no pain, no vomiting, and patient expressed him self as decidedly more comfortable, the continuance of exquis ite tenderness, together with the dullness over right iliac region, the increase of tympanites and pulse-rate, and the exam ple of three previous fatal cases, induced me to believe that the time for action had arrived. I told the mother that as a sur gical operation of serious nature might become necessary, I would like to have Dr. Sands to see patient at the earliest pos sible moment.

At the time of our first consultation the boy was quite ill with what was believed to be peritonitis. Pulse, 130; temper ature,101'6° F.; respiration, 3 Abdomen moderately dis tended and painful, the pain being most marked in the right iliac region, which was also exquisitely sensitive and slightly dull on percussion. Careful examination of this region failed to discover any tumor, nor could any swelling be felt when the forefinger was introduced into the rectum.

I diagnosticated the case as one of acute septic peritonitis, caused by perforation of the vermiform appendix, and advised an immediate resort to laparotomy. Dr. Baruch replied that, while be fully approved of my proposal, the family would be unwilling to consent to so serious an operation without further counsel, and it was accordingly agreed to make every necessary preparation for the procedure, and to ask Dr. Lange and Dr.

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