The management of accidental puncture and other injuries of the gravid uterus, as complications of laparotomy / by Charles Carroll Lee.

  • Lee, Charles Carroll, 1838-
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: The management of accidental puncture and other injuries of the gravid uterus, as complications of laparotomy / by Charles Carroll Lee. 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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    ing emptied the cyst, he wounds the uterus while separating some dense adhesion. What is to be done ? These accidents have all occurred in cases that have been frankly placed on record, and there is grave reason to believe they have all happened in fatal cases that have never seen the light. Let me glance briefly at the literature of the subject, which is too scanty to try your patience long : Case I.—In Dr. Lyman’s Boylston Prize Essay on Ovari- otomy,, Boston, 1856, the first three hundred cases of ovarioto- my then published are tabulated. In this list, Case 269, reported by Dr. Sargent, of Worcester (name of operator un- known), was abandoned on account of extensive adhesions. The abdominal incision was made to the right of the umbilicus and below ; the supposed cyst was punctured by a large trocar, on withdrawing which, a pint of pure blood escaped. The pa- tient died on the third day of peritonitis, and at the autopsy only was it discovered that the gravid uterus had been tapped. The character and location of the cyst are not mentioned. In the second volume of the Medical Times and Ga- zette for 1862, page 277, is narrated the following case, for reference to which I am indebted to Dr. H. J. Garrigues: Case II.—A married woman was admitted to St. George’s Hospital, London, under the care of Mr. Pollock. Nine months before, she noticed a tumor in the right side, which increased so rapidly that it was tapped. Soon afterward she aborted. The swelling soon returned, and she was tapped a second time, as the distension was very great. Five weeks after this, ovari- otomy was performed by Mr. Pollock, as the cyst again re- filled. An incision six inches long exposed a multilocular ova- rian tumor. A large cyst in front of this was tapped and emptied, and the whole of the tumor removed. Behind this at once appeared another fluctuating tumor, which was thought to spring from the other ovary. It was tapped, and clear watery fluid flowed out. On trying to lay hold of it, this was found to be the gravid uterus, containing a dead fetus ; it was therefore not interfered with beyond clos- ing the wound in its wall with silver sutures. There was little