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Article
January 16, 1909

RESECTION OF CECUM AND LOWER PORTION OF ILEUM: FOR FECAL FISTULA RESULTING FROM PERFORATION OF AN ACUTE GANGRENOUS APPENDIX

Author Affiliations

TILLAMOOK, ORE.

JAMA. 1909;LII(3):211. doi:10.1001/jama.1909.25420290037002a

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Abstract

Patient.  —C. R. J., a man, aged 46, weighing 240 pounds, had been ill for two weeks when I first saw him.

Examination.  —The patient had a temperature of 103.2 F., cold clammy sweat, rapid feeble pulse, and complained of great pain in the lower abdomen and right side, where there was a large mass extending upward to the lower border of the ribs on the right side. By abdominal palpation I found extensive induration over McBurney's point extending one inch to the left of the median line. No pus had been passed by rectum. A diagnosis of acute perforative appendicitis with abscess was made.

First Operation.  —I made an exploratory incision over McBurney's point, two inches in length, and going carefully through the peritoneum, found a large walled-off abscess, which ruptured as soon as I had opened into the peritoneum. Large quantities of pus and fecal matter of a

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