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Updated: June 6, 2025
"Moreover, the bacterial finding of streptococci and cold bacilli in the perityphlitic abscess is typical, and the limitation of the diffuse peritonitis to areas below the omentum is also instructive. This simultaneously prevented the invasion of organisms producing inflammation into the serous surfaces above." "This strong man, aged 31, had previously regarded himself as perfectly well.
His wound was dressed and he was recovering, but on September 11th he tore the cast off his abdomen, and pulled out of the wound the omentum and 32 inches of colon, which he tore off and threw between his pallet and the wall. Strange to say he did not die until eight days after this horrible injury.
The omentum, and particularly the portion opposite to the external disease, was also inflamed. Besides this there was not a vestige of disease. This is an interesting case and deserves record. I fear that justice was not done to the animal at the commencement of the paralytic affection.
There is an account of such a case in a woman of seventy-two living in Pittsburg, who, after a spasmodic cough, had a spontaneous rupture of the parietes. The rent was four inches in length and extended along the linea alba, and through it protruded a mass of omentum about the size of a child's head. It was successfully treated and the woman recovered.
The gall bladder was distended with a dark, muddy-looking bile. The mesentery, stomach and intestines were excessively thin and transparent. There was no fat in the omentum." In cases of complete abstinence, the phenomena to several of which attention has already been called are very striking.
A postmortem showed the abdominal cavity to be full of blood; at Douglas' culdesac there was a tear large enough to admit a man's hand, through which protruded a portion of the omentum; this was at first taken for the membranes of an abortion. There were distinct signs of acute peritonitis.
And ever and anon the master turned to his book, as he laid bare the mysteries of the hidden organs; to his precious Vesalius, it might be, or his figures repeated in the multifarious volume of Ambroise Pare; to the Aldine octavo in which Fallopius recorded his fresh observations; or that giant folio of Spigelius just issued from the press of Amsterdam, in which lovely ladies display their viscera with a coquettish grace implying that it is rather a pleasure than otherwise to show the lace-like omentum, and hold up their appendices epiploicae as if they were saying "these are our jewels."
On May 3d abdominal section was performed. An incision eight inches long was made in the mid-line of the abdomen. A cystic tumor, formed of small cysts in its upper part and of somewhat larger ones in the lower part, was revealed. It was adherent to the abdominal wall, liver, spleen, and omentum.
A relative of the deceased now jumped up, with his weapons, violently excited, and apparently with the intention of spearing some one; but he was at once restrained by his friends, who informed me that the investigation had satisfied them that the man had not died through the agency of sorcery; if he had, it is imagined that a cicatrice would have been found upon the omentum.
The sac was filled with blood, both fresh and clotted. There was a ragged wound in the anterior wall 1/2 inch in diameter. The wound of exit was 5/8 inch in diameter. After traversing the heart the ball had penetrated the diaphragm, wounded the omentum in several places, and become lodged under the skin posteriorly between the 9th and 10th ribs.
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