Lectures to General Practitioners On the Diseases of the Stomach And ...

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Lectures to General Practitioners On the Diseases of the Stomach And ...
Boardman Reed
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Obstruction due to plugging by gall stones, enteroliths, foreign bodies, hard fecal masses, etc., is seldom complete at first, and for this reason as well as because of the fact that no violence has been done to the mesentery, and the interference with the local circulation of the part in the beginning is but slight, there is a mildness of the early symptoms in marked contrast to those of the forms dependent upon strangulation. The pain is usually much less intense, and is not accompanied by vo...miting at first. Some gas, and often even a part of the feces, may pass the obstruc- 696 THE GASTRO-INTESTINAL CLINIC tion, and in consequence marked distention is much later in developing.
When a gall stone is the obturator, whether or not it has been enlarged by successive accretions into an enterolith, the patient will generally have had previous attacks of hepatic colic accompanied, as a rule, by jaundice, bile-stained urine, fever, etc. There will also be often a persisting tenderness in the region of the gall bladder.


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