A NEW METHOD OF DIAGNOSIS OF PERITONITIS IN INFANCY AND CHILDHOOD

BERNARD DENZER
1920 American Journal of Diseases of Children  
It is generally recognized that the diagnosis of peritonitis in childhood and particularly in infancy presents a difficult problem. Peritonitis is frequently found at necropsy, when it had not been suspected during life, and, on the other hand, it is often impossible to exclude peritonitis as the cause of obscure febrile conditions in infancy. Our purpose was to obtain a specimen of peritoneal fluid in order to determine the initial reaction to the inflammatory process. Aspiration has several
more » ... ation has several disadvantages. First, a comparatively large amount of fluid must be drawn through the metal needle and into the barrel of the syringe before one can observe whether fluid has been obtained. Second, aspiration is apt to suck omentum or intestine to the needle point, damage the intestine, or, at least, block the needle and thus prevent the aspiration of fluid even though it may be present. Furthermore, we believe that aspiration has been attempted, and that it has been discarded or at least has not proved of sufficient value to warrant further trial. The classical Pfeiffer experiment, in which a capillary tube is inserted into the peritoneal cavity of a guinea-pig and fluid obtained by capillary attraction, suggested the procedure we finally adopted. Glass needles have been used. They were prepared from glass tubing %6 inch thick with a bore of about V32 inch, and were drawn to a point and beveled. In order to add siphonage to the force of capillary attrac¬ tion and obtain a larger amount of fluid, a bulb was blown and the tubing bent. METHOD OF PROCEDURE The procedure is as follows : the skin of the abdomen is swabbed with iodin and the usual precautions are taken to determine bladder distention. A steel needle, about number 17 gage, is used to punc¬ ture the skin in the midline about one-half inch below the umbilicus. The glass needle is inserted through this opening and then, held almost perpendicular to the surface of the skin, it is firmly pushed inward until the sudden release of pressure indicates that the needle has
doi:10.1001/archpedi.1920.01910260039004 fatcat:4p5hv7kpnvhojeuebudpvbegli