Irish Masters of Medicine
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چکیده
small crumb of comfort, in that the obstruction does not give rise to definite signs and symptoms, whereas each positioIn of the appendix gives a train of signs and symptoms that are capable of interpretationi. Everv anatomical conditionl of the appen(lix an(d its surroundinigs has tllhen a (lefiniite bearitng oni the symptoms whlien the appendix becomiles diseased. Whlienl a suspecte(l case of appetndicitis is approached, the diagnosticiani shouldl ask limself wvhat is the probable anatomical cond(ition present, and are the signs and( sy-mptoms of the patient coincident with such a conI(litionl. If the anatomical conditions agree with thc signls anidl symiptoms, the diagnosis is correct. Knowing the anatomical conditions, the diagnosticianl can wvith greater confidelnce determine the next step to be takien. An appenidix in the splenic positioIn brooks no delay, neither does a pelvic one. On the other halnid, if there is reasonable doubt about a lateral cecal append(iix, a few houirs' (lelav for thc examniniationi of the urine, or an X-ray examinationi of the urinarv tract, xvill not lowe r appreciably the chlainces of the patienit. For the surgeon the position of the appendiix ill detei-nille tihe incision to be used, Ihis great aim being to deliver the appcndix with least (listtlrbatnce to t-hec peritoneal cavity ani(l to the abdominal wall. In conclusion, I shouldi like to thank my colleagues at the Ulster Hospital for Children, Templemore Avenue, for permission to include some of their cases in the figures, andl also to the house-surgeon, Dr. Christie, and the sisters, for their help in getting the histories of the patients an(d the care they have taken over the temperatures. I am also greatly indebted to Mr. S. 'T. Irwin for his generosity in allowing me to operate under local anasthesia upon patients in his ward, and to the staff of the Royal Victoria Hospital for permission to examine their casesheets in the Royal Victoria Hospital.
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عنوان ژورنال:
- The Ulster Medical Journal
دوره 2 شماره
صفحات -
تاریخ انتشار 2008