Primary sarcoma of the peritoneum / by J.M. Elder.

  • Elder, John Munro, 1859-
Date:
1908
Catalogue details

Licence: In copyright

Credit: Primary sarcoma of the peritoneum / 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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    The coils of intestine were much thickened and nodular, feeling like strands of rope, and were very adherent to one another. The mesenteric glands were very large and hard. The abdomen was hurriedly closed with through and through sutures, as the patient took the anjesthetic badly, and his pulse was very weak. After operation the patient grew steadily worse, the tem- perature being mostly subnormal, and the pulse weak and rapid, until he died on the evening of the second day after operation. Excerpts from autopsy record of W. R. with particular RELEVANCY TO THE DEGREE AND CHARACTER OF MAIN TUMOR AND ITS METASTASES. (SERVICE OF Dr. ElDER.) Peritoneal Cavity.—Upon opening the abdomen a moderate amount of salmon-colored, turbid, watery pus flows out. The omentum is large and covers the whole of the intestines, being wrapped into both loins and extending into the pelvis. It is much thickened in places, measuring about 1.5 cm. in thick- ness; this is due to numerous small nodules of soft, friable, greyish-pink material, some' being distinct and others confluent. On section these nodules are homogeneous in appearance and soft. The borders of the omentum are especially filled with this tissue. The vessels are dilated. There are several dilated veins extending from tht omentum across the transverse colon and gastrocolic omentum to the lower border of the stomach. The parietal peritoneum, in the neighborhood of the spleen, is thickened to about i cm., moderately firm, but friable. On section, this thickening is seen to be du6 to infiltration with a tumor mass similar to that found in the omentum. The parietal peritoneum in the pelvis, especially that lying between the bladder and rectum, is similarly infiltrated. The Mesenteric Lymph Nodes are enlarged, the largest being about the size of pigeons’ eggs. The whole mesentery, too, is thickened to about i cm. The surface of the mesentery contains purplish blotches. On section the enlarged glands and mesenteric tissue are seen to consist almost entirely of homogeneous, greyish-pink, soft, mod- erately friable tissue similar to that seen elsewhere. In certain areas there is definite evidence of a hemorrhagic condition. Covering the whole of the large bowel and looking like large appendices epiploicae are numerous areas measuring from 2 to