Clinical papers / by J. Halliday Croom.

  • Croom J. Halliday (John Halliday), Sir, 1847-1923.
Date:
1901
Catalogue details

Licence: In copyright

Credit: Clinical papers / by J. Halliday Croom. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    The impression on her admission to iiospital was, that tlie tnmour was a pregnancy, notwithstanding her extreme youth, and tliis was very consideral)ly empluisised l»y the fact that lier mamnue were largely developed, that there was a well- marked linea nigra passing from the nmhilicus to the pubis, tliat there was a co})ious develojmient of hair over tlie mons veneris and the external surface of tlie laljia majora, as shown in the accoinjianying illustration, and that a well- marked bruit could he heard on both sides of the tumour. The tumour was freely movable, tense, and firm, but had apparently no intimate connection with the jielvis. This want of connection with the cavity of the pelvis, as well as its absolute solidity, notwithstanding the apparent indications otherwise, decided me against the jiossihility of pregnancy. Under anaesthesia, therefore, I examined the patient per vaginam, and found the remains of the hymen thick, but completely penetrated, the vaginal walls being smooth, and the cervix enlarged, very soft, and somewhat patulous. The sound was then introduced into the uterus, which was found to be enlarged, being slightly over 3 in. This manipulation caused free luemorrhage. The possibility, then, of pregnancy in a hihorned uterus naturally presented itself, hut a pro- longed examination of the patient—by no means an easy matter in a child—satisfied me that the tumour was uncon- nected with the uterus, as this organ could be mapped out l)imanually, and the conclusion arrived at was that it was a pediculated ovarian. In considering the question of pregnancy, the pelvic measurements were taken, and found to he—interspinous, 8 in.: intercristal, 8| in.; external conjugate, 6j in. It is especially noteworthy tliat tlie development of her pubic hair, the uterine lifemorrhage, and the growth of tlie abdominal tumour, as well as the appearance of the linea nigra, were all phenomena entirely subsequent to the interference with her genital organs, and therefore apparently conseiiuent u]ton