Congenital hypertrophic stenosis of the pylorus / by Edmund Cautley.

  • Cautley, Edmund, 1864-1944.
Date:
[1899]
Catalogue details

Licence: Public Domain Mark

Credit: Congenital hypertrophic stenosis of the pylorus / by Edmund Cautley. 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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    pyloric obstruction^ for it is generally accej)ted that the stomach of infants is emptied in about two hours^ time. 2. The bowels.—Constipation, though a common sym- ptom, is not as invariably present as would be expected. In the early stages, and even in later stages when the obstruction is not complete, there may at times be diarrhoea. This is due to irritation from decomposing food retained in the stomach, the irritating products passing on into the intestines. Generally the stools are small, and present no obvious alteration. In some cases constipation is a very marked symptom, the bowels not being open for eight days (Case 3), or only open by means of enemata (Case 19). Even during the last fortnight of life there may be diarrhoea, but, as a rule, there is obstinate constipation. 3. The tongue.—The character of the tongue varies according to the absence or presence of secondary gastric catarrh. It may be clean throughout the illness (e. g. Case 5), and at the same time the breath may be quite sweet. Or the breath may be sour and the tongue coated with a thin white fur. 4. The abdomen.—On inspection there are no signs of intestinal obstruction. The abdomen is flat and thin. There may be a distinct swelling in the epigastrium and the usual signs of a dilated stomach. On the other hand, it must be remembered that vomiting takes place with such great ease in infants that there may be no very definite increase in the size of the stomach. A dilated stomach may also occur in conditions unconnected with pyloric obstruction. It may be possible to demonstrate the presence of a tumour in the region of the pylorus. Finkelsteiu demon- strated an enlarged hard pylorus (Case 12), and Thomson found a hard moveable tumour in the epigastric region (Case 9) during life. 5. General condition.—There are all the signs of star- vation. The child is very wasted, and continues wast- ino-. The surface of the body is cold, and the tern-