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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    perature is subnormal. The pulse is frequent, small, and weak. The child lies in a condition of lethargy, with half-open eyes, and takes no interest in its surround- ings. It occasionally cries from pain, and rouses a little to vomit. Food is not taken with avidity, and is often refused. Morbid Anatomy. There is great emaciation. All the organs of the body are free from the signs of disease with the exception of the alimentary tract. In one case (No. 4) tuberculosis of the lung and secondary dissemination were present and caused death, the stenosis not being at all extreme although the pyloric hypertrophy was well marked. The oesophagus may or may not be dilated, dilatation depending on the degree and duration of the obstruction. The stomach generally presents more or less dilatation, sometimes extreme, in which case its walls are thinned. The contents consist of undigested food and mucus, and occasionally small particles of blood. The mucous mem- brane is normal unless there has been co-existent gastric catarrh, in which case the ordinary signs of this condition will be found. In some infants the muscular walls of the pyloric end of the stomach have been found somewhat hypertrophied. I could not satisf} myself that such hypertrophy was present in my cases. The pylorus is represented by a very definite tumour, which has been described as an intermediate piece, a ^‘cylindrical swelling,’^ and as a “ sausage-shaped tumour.It varies a little in size, but may be taken roughly as about the size of the last joint of the little finger, and about an inch long. On external examination with the fingers the limits of the tumour can be definitely fixed both on the duodenal and the gastric side; to the touch it ends more abruptly on the duodenal side, but there is also a very distinct limit to it on the gastric side. It is very firm and hard. If the duodenum is laid open and the pylorus looked at from that aspect, it