On a case of internal strangulation of the bowel by a band, associated with a reducible hernia : successfully treated by operation, with remarks / by Thomas Bryant.

  • Bryant, Thomas, 1828-1914.
Date:
1867
Catalogue details

Licence: Public Domain Mark

Credit: On a case of internal strangulation of the bowel by a band, associated with a reducible hernia : successfully treated by operation, with remarks / by Thomas Bryant. 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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    scrotum, which had existed five years, and for which he had worn a truss; a small portion of the hernia, however, had always been down. When his symptoms first appeared the hernia had suddenly enlarged and he was unable to reduce it. Mr. Green was sent for, and returned a portion of the con- tents of the sac, but the symptoms continuing, he sought my advice. When I saw him he was vomiting a yellow bilious fluid, and was in severe pain about the umbilicus. His abdomen was neither very tense nor very tender upon manipulation. The scrotal hernia was large, but flaccid and painless. His countenance denoted extreme anguish. Pulse small and rapid; skin bedewed with a cold sweat. The symptoms of intestinal obstruction being thus very marked, and a hernia existing, chloroform was given, and under its influence an attempt was made to reduce the con- tents of the hernial sac, but with no permanent efiect; for although a portion was returned and the patient asserted that the hernia had been reduced to its natural size, the symptoms persisted and soon became aggravated, paroxysms of pain attacking the patient. Three hours subsequently herniotomy was performed; omentum was alone found in the sac, but no intestine; the mass of omentum had evidently been down for some years. The finger could be readily introduced into the abdomen, but no signs of strangulation by any of the parts which had entered into the formation of the hernia could be made out. After the operation the patient expressed himself as being relieved. Opium was ordered in full doses. The next morning (20th) he was more comfortable, having- passed a tolerable night; he had vomited but once, an hour after the operation, and had been free from any severe paroxysm of pain; his abdomen was firm, but not much dis- tended. He was ordered to continue the opium. On the evening of the 21st I was hastily called to see him, as he had been again seized with a severe paroxysm of abdominal pain. I found him with a cold clammy skin, sunken eye, and almost imperceptible pulse. His abdomen