Hysteromyomectomy : with a report of four cases / by Hunter Robb.

  • Robb, Hunter, 1863-1940.
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: Hysteromyomectomy : with a report of four cases / by Hunter Robb. 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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    incision in median line, 17 cm. long, closed by 11 sutures. The wound covered over with a dressing of iodoform and celloidin. Epidermis macerated along the edges of the wound, wound other- wise dry. Abdomen slightly distended, omentum and intestines slightly adherent to abdominal wound. The anterior parietal peritoneum injected, cloudy and covered with slight exudation. Foci of ecchymosis in various places. Intestines somewhat distended, in places slightly adherent, cloudy, and covered with a very slight fibrinous exudation. Blood-vessels more injected than normal. In the peritoneal cavity about 50 cc. of bloody fluid. The entire pelvic cavity filled up with a bloody brick-dust colored fluid, and pretty well shut off from general peritoneal cavity by a projecting mass of tissue (the stump remaining from operation), and by adhesions of this to the intestines and peritoneal wall. In places between adherent loops of intestines there is considerable fibrinous hemorrhagic exudation. Lungs.—Diaphragm on right side at lower border of third rib, on left Bide at fourth intercostal space. Both pleural cavities moist. Both lungs slightly adherent by a few old adhesions. Anterior borders of both lungs slightly emphysematous. The posterior and inferior portions of left lung deeply congested and cedematous, with apparently small areas of more intense congestion, with very slight hemorrhage. Right lung shows essentially same condition. Heart.—Both layers of pericardium smooth. Left ventricle firmly contracted. Myocardium pale, rather soft. In both ventricles fluid blood and dark clots. Thickness of left ventricle 18 mm., length 7.5 cm.; of right ventricle, 4 mm., length 8 cm. Aorta, 7 cm.; mitral, 9 cm.; tricuspid, 12.5 cm. ; weight, 320 grms. Liver and spleen free from adhesions. Liver weighs 1250 grms., small, size 23x15x7 cm. Surface smooth, border sharp, of light brown homogeneous color, with small opaque areas scattered over the surface. On section very pale, lobules not visible, opaque looking, the paler areas not so conspicuous as on surface. Bile- duct free. In gall-bladder a small amount of viscid dark bile. Kidneys.—Weigh together 225 grms.; both have the same general appearance and size. Capsule easily stripped off. In both kidneys deep depressions from remnants of fcEtal lobulations, and in addition small irregular depressions. Color pale ; stellate veins not injected. On section pale, markings very obscure. Cortex 6 mm. Distinction between cortex and pyramids not so clear. Spleen of a pale red-brown color ; capsule smooth ; weight, 150 grms. Malpighian bodies not visible. Trabeculae visible, con- sistency firm. Fundus of uterus, ovaries and portion of broad ligament missing. A heavy ligature tied around the stump, at end of which there are interrupted ligatures. The whole permeated with iodoform. Stump is bloody and the numerous vessels enclosed in it are filled with coagula.