On the management of true and false capsules in ovariotomy / by Alban Doran.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927.
Date:
1898
Catalogue details

Licence: Public Domain Mark

Credit: On the management of true and false capsules in ovariotomy / by Alban Doran. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    4/12 (page 4)
    cyst. The capsule was therefore fixed to the parietes, and plugged with sterilised iodoform gauze, which was removed on the third day. Thus haemorrhage was stopped and sepsis averted. The author discusses the advantages and dangers of iodoform plugs. He also dwells on the prejudice of many surgeons against the practice of fixing the capsule to the wound. The danger of strangulation from a loop of intestine slipping beneath the capsule is theoretical. Over a year ago I demonstrated, at a meeting of the West London Medico-Chirurgical Society, the nature of a capsule associated with an ovarian cyst. I showed that Pawlik* was right when he insisted that the word “ capsule ” meant at least two different pathological conditions. I read notes of six cases in my own practiced which proved the truth of Pawlik’s theory. Finally, I laid stress on the importance of a thorough knowledge of capsules. I concluded by remarking that if the surgeon persists in doing ovariotomy without any pathological knowledge, he must not be surprised if he loses cases, and finds after death that he has torn up the peritoneum of Douglas’s pouch, lacerated a ureter or large vein in the wall of the pelvis, mistaken intestine, adherent to and stretched on the cyst, for the tube stretched over a true capsule, or committed some other deplorable error. The management of a false capsule which consists of inflammatory deposit, mesentery, or omentum, is hardly a subject of controversy. It is simply a question of break- ing down adhesions. The importance of false capsules lies in their recognition, and not in their treatment. I am referring to the genuine inflammatory variety, which might be henceforth termed Pawlik’s capsule, for the sake of bi’evity. By a true capsule I mean the mesosalpinx, the lower part of the broad ligament being not opened up. But # ‘ Ueber pseudo-intra-ligamentose Eierstocksgeschwiilste/ Vienna, 1891. f “ Capsules, False and Heal, in Ovariotomy, with Notes of Six Cases/ ‘ Brit. Med. Journ./ 1896, vol. i, p. 960.