File:Diseases of children (1916) (14786073063).jpg

Identifier: diseasesofchildr00grah (find matches)
Title: Diseases of children
Year: 1916 (1910s)
Authors: Graham, Edwin Eldon, b. 1864
Subjects: Children Disease
Publisher: Philadelphia and New York, Lea & Febiger
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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temperature ascendsbecause of the toxemia and peritonitis, the childs face assumes ananxious expression, and it finally dies in collapse. Diagnosis.—The diagnosis of intussusception can be made with cer-tainty in any case where there is a history of sudden severe pain,vomiting, and bloody stools, and when a tumor can be felt along theintestinal tract. The sudden onset, the violence of the symptoms, theabsence of fever, the shock, sharply differentiate this disease from ileo-colitis, gastro-enteritis, or other intestinal inflammation. Prognosis.—During infancy an attack of intussusception runs a rapidcourse; and, in the majority of cases, unless relieved spontaneouslyor by operation, will terminate in death within five days. The earlierthe operation and the older the child the better the outcome. Sub-acute and chronic cases offer a more favorable outlook than do those ofthe acute type, in which the chances of recovery are reduced consider-ably by each succeeding day of the disease,
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Fig. 30.—Drawing of specimen from a case of intussusception in an infant. Inthe diagram the letters have the same signification. A A, colon; B, point where theileum enters the intussusception. The letter B points directly within the intestinallumen. A probe passes in at B and comes out at C. The diagram illustrates the coursewhich it must pursue. D is the appendix; E, point of constriction of the ileum; F,point of slight.eversion where the serous coat turns to pass within the bowel; G showsthe line of constriction in the ileum caused by the ileocecal valve. The specimen hasbeen pulled through the valve to show this line of constriction and the gangrenousmass of intestine beyond extending from G to C. This point of constriction in thediagram is indicated by a slight depression at G. H, I and J show the line of attach-ment of the mesentery. Between H and I, and extending slightly beyond the line /,is a fold produced by pulling the intestine through the ileocecal valve sufficiently far

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