Tumors of the abdominal walls / by Edward J. Ill.

  • Ill, Edward J.
Date:
[1892]
Catalogue details

Licence: Public Domain Mark

Credit: Tumors of the abdominal walls / by Edward J. Ill. 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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    suppurating or non-suppurating. Any of the various layers may be the seat of such an inflammation. They are the more serious the nearer they are to the peritoneum, and the lower they are on the abdomen and in the subperitoneal cellular tissue—the latter for the reason that pus is apt to gravitate down into the loose cellular tissue about the bladder, and thus seriously endanger life. The etiology is not always easily discerned. Traumatism is a frequent cause. Thus I have seen a large abscess in the rectus abdominis of a negro, resulting from the kick of a horse. This case resulted even though no disturbance in the continuity of the skin was observed. An inflammation or rupture of an abdominal muscle, especially of the rectus, following typhoid fever, is no uncommon cause of abscess. Gunshot and stab wounds, as well as hypodermic injections, are a frequent cause of suppurative tumors. The diagnosis is easy as soon as fluctuation can be discerned, and is very difficult in the chronic form of the disease, especially when deep-seated. The following case will, I think, form an illustration of the chronic form : Case I. Tumor of the abdominal wall simulating a solid growth; operation; abscess; cure.—Mrs. J. S., aged forty-five years, was referred to me by Dr. Gray, of East Orange, on April 12, 1892. She suffered with occasional attacks of gastralgia for years. Some weeks ago the Doctor noticed, during one of these attacks, that she had a tumor half- way between the umbilicus and ensiform cartilage. It was painful only when pressed upon. At the above date it gave her no incon- venience, except that it was sore when the corset bore against it. She had no fever. The woman is rather stout; has a tumor in the median line measuring five by seven centimetres, with sharply defined outline. The long axis of the tumor is in the long axis of the body. It is not painful on being handled, is freely movable when the muscles are relaxed, and fixed when they are contracted. It is hard and solid to the touch, and its posterior surface smooth so far as it can be reached. The diagnosis of a solid tumor of the muscles or deep fascia was made, and the patient asked to return for observation in two weeks. On April 26th she returned ; there was no fever and but little pain. The tumor now measured seven by nine centimetres. The rapidity of its growth was suspicious as to its nature. On May 1st, while under an anesthetic, the great mobility of the tumor and its freedom from any adhesions in the abdomen were remarked upon, as was also a slight