Page:Transactions of the Royal Society of Tropical Medicine and Hygiene, volume 3 (2).djvu/6

 The history of this case of Œsophagostomiasis is unknown. The patient, a man, æt about 36, a native of the Amazon State, came from the River Purus region. He was admitted to the public ward of the Santa Casa in Manaos as suffering from dysentery. He became delirious and died within three days of entrance. The autopsy was performed ten hours after death.

On opening the abdomen a chronic peritonitis was seen, involving the right side and matting the omentum and coils of the email intestine to the cæcum and ascending colon. The small intestine was distended with gas. The spleen was not enlarged, but there was a marked perisplenitis. The capsule of the organ was thickened in places and there was a cartilaginous area on the superior surface, the size of a florin. The diaphragm was free; the liver, kidneys, etc., were partly decomposed, but showed cloudy swelling.

As the adhesions were very firm, the small intestine, caecum, ascending and transverse colon, were taken out en masse, and placed in Kaiserling's fluid for later examination.

On examination of the bowel, nodular cystic masses were found involving the outside of the walls of the ileum, cæcum and colon. In separating the adhesions, one of these cysts were ruptured, and a small worm was easily pressed out.

About one metre's length of the small bowel from the ileo-cæcal valve is studded with small raised dough-like tumours. The greater number involve the lower part of the ileum for a distance of 35 cm. from the ileo-cæcal