Report of cases of uterine fibroids associated with gallstones / Albert Vander Veer.

  • Vander Veer, A. (Albert), 1841-1929.
Date:
1906
Catalogue details

Licence: In copyright

Credit: Report of cases of uterine fibroids associated with gallstones / Albert Vander Veer. 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.

    7/12 (page 4)
    cholecystotomy is not a prolonged one, and is very easily accomplished. When once the hand of the operator is in the peritoneal cavity the incision can be made very quickly, the gall bladder, if not too contracted, and far back, is easily brought up into the wound and reached in this manner. It took many years to convince the general practitioner that the surgeon could be of assistance in his abdominal cases and reports of cases of rare complications are yet in order to bring before him more clearly what and how much can be done by the general surgeon in the treat- ment of lesions, no longer medical, but assuredly sur- gical. How many operations can be done on one patient at one time is yet a subject for close study by both the medical man and the consulting surgeon. Case 1.—Mrs. C., aged CO, entered Albany Hospital, May 2, 1902. Diagnosis.—Papillomatous ovarian cyst; cholelithiasis. History.—She gave a family history of a sister and niece having died of sarcoma of the ovaries and mesentery. The patient had been ill for more than a year with gradual en- largement of the nbdomen and more or less pain. Operation.—On opening the nbdomen there was an escape of a large amount of yellowish serous fluid. There were cysts connected with each ovary. The right broad ligament was clamped; the left broad ligament was sutured at once; then the appendages with the cystic tumors were removed and a supravnginal hysterectomy was done. An enlarged gland in the mesentery closely attached to the rectum was removed and the walls of the rectum were sutured over. There were extensive adhesions to the wall of the bladder and to the an- terior wall of the uterus. In removing the latter a large por- tion of the posterior wall of the bladder was included. This opening in the bladder was closed with silk sutures. Hem- orrhage was controlled. The gall bladder was found to con- tain many gallstones—over 100, and the usual cholecystotomy was done. The appendix was also removed. The wounds were closed with silkworm gut; a glass drainage tube was in- troduced into the bottom of pelvis and also into the gall bladder. The patient bore the anesthetic very well. Drainage from peritoneal cavity subsided quickly and the gall bladder closed in about two weeks. She left the hospital in good condition June 8, 1902. Pathologic Report from the Laboratory.—Multilocular ovarian cyst with secondary papillomatous and carcinomatous* degeneration. Subsequent History.—The patient did well for a time, then