Single ulcer of the urinary bladder, non-tuberculous and non-malignant : with report of cases / by George E. Armstrong.

  • Armstrong, George E., 1854-1933.
Date:
[1903]
Catalogue details

Licence: In copyright

Credit: Single ulcer of the urinary bladder, non-tuberculous and non-malignant : with report of cases / by George E. Armstrong. 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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    were: frequency of micturition, pain during and after urination, suprapubic and at the end of the penis. He had suffered from lead colic. No tubercle could be found in any part of the urogeni- tal tract or elsewhere, nor was the tubercle bacillus to be found in the urine. Had only passed sufficient blood to color the urine on one occasion. Through a suprapubic incision the cavity of the bladder was found to be small and the walls hypertrophied, but otherwise healthy, except for a small ragged irregular ulcer with granular surface and thin edges, and about 1.9 cm. in diameter, between the two ureters and on the posterior part of the trigone. When it was touched over with swabs of wool wet with carbolic acid (1 : 20) the surface bled readily. There were no signs of caseation or tubercles anywhere, and the ulcer looked more like an anal ulcer than anything else. The ulcer was not found indurated or perforating, and was quite unlike a gastric ulcer. There were no signs of malignant disease. The bladder was drained supra- pubically and washed out with a solution of borax and iodine for twenty-eight days. In about two months he gained two stone in weight, and left the hospital apparently cured. On January 7th of the present year Daly and Harrison9 reported a case of spontaneous rupture of the bladder occurring in an Irish harvester, aged thirty-six years. The man was seized with pain while carrying a pail of water with which to wash himself. At the operation an intraperitoneal rent was discovered of sufficient size to admit the tip of the index finger. This was sutured with two layers of Lembert sutures, the mucous membrane not being in- cluded. The rent was situated midway between the fundus of the bladder and the bottom of Douglas’ pouch, and was vertical and central. Notwithstanding some deplorable complications, the man made a good recovery. Rawson10 reports the death of a woman, aged thirty-five years, taken suddenly ill, and dying in thirty-six hours. At the autopsy a small ulcerated opening was found at the summit of the bladder. The mucous membrane of the bladder for the breadth of half an inch around the opening was highly injected with blood, and was of a much darker color than the rest of the mucous lining. Purulent