On the closure of the ostium in inflammation and allied diseases of the Fallopian tube / by Alban Doran.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: On the closure of the ostium in inflammation and allied diseases of the Fallopian tube / 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.

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    vative operation above noted leaves too much to chance, for the breaking down of adhesions around the ostium is likely to cause enough irritation to set up fresh inflamma- tion, which would rapidly seal up the ostium again. The dangers of any incomplete operation are considerable, even in simple cases of recent obstruction. In pyosalpinx no such proceeding could be justified. Lastly, the pains and dangers to which the patient is exposed in diseases of the tube may not be entirely due to tubal obstruction. The draining of a pyosalpinx through an abdominal incision may prove satisfactory in some cases, but it does not restore the tube. The most promising method of restoring an obstructed, non-suppurating tube to its func- tions is perhaps that suggested by Dr. Skutsch, of Jena, and carried into effect by him in one case with fairly satisfactory immediate results. He has devised an opera- tion which he terms “ salpingostomy.” It was described before the third meeting of the Deutsche Gesellschaft fur G-ynakologie at Freiburg in June, 1889 (see ‘ Centralblatt fur Gynak./ No. 32, 1889). He operated upon a sterile patient, aged thirty-eight, with moderate dilatation of both tubes, which is said to have caused great pain, the ovaries and uterus being apparently free from disease. Some of the fluid contents of each tube were first withdrawn by means of a Pravaz syringe, and found to consist of clear yellow serum free from pus. The ostium was then laid open, the fluid allowed to escape, and an oval piece of the wall, about one square centimetre in size, cut away. The mucous membrane and serous coat were united along the margin of the artificial aperture by fine silk thread. Lastly, a sound was passed through the aperture along the tubal canal into the uterus. Convalescence was un- interrupted. “ From the day of the operation forward the woman was free from pain.” The principle of salpingostomy is sound, and should the plicae be restored through the relief of tension, it is highly probable that those near the artificial opening would ulti- mately bulge and form fimbriae, just as is seen, as already