Haematoma and haematocele : a study of two cases of early tubal pregnancy / by Alban Doran.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927.
Date:
1904
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Licence: In copyright

Credit: Haematoma and haematocele : a study of two cases of early tubal pregnancy / 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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    statistics are familiar to us all,* but Lockyer also dwells upon the opinion of Veit. That gynaecologist lays down a principle in direct contradiction to Taylor’s teaching. “We cannot assert,” says he, “that when the ovum is dead dangers are absent. We can, however, state that subsequent to death of the ovum a favourable termination is much more probable. These cases will mostly recover without help.” Lockyer himself concludes that the conservative treatment of ectopic pregnancy in the earlier months has established for itself a secure position in modern gynae- cology. It is specially satisfactory in the treatment of tubal mole and diffuse haematoceles. Gossmann also believes in the frequency of spontaneous cure.t When we turn to haematoma, sometimes called extra- peritoneal hannatocele, Taylor differs from many of us as to its relation to ectopic gestation. He demonstrates how a tubal sac may burst so as to discharge the ovum into a space which it makes for itself by forcing apart the layers of the broad ligament. In consequence, an anterior or posterior tubo-ligamentary pregnancy develops. Taylor’s theory is generally accepted, being based on sound anatomical and pathological evidence, and in fact we all admit that the ovum may lie between the layers of the broad ligament. That being the case we must further allow that blood from a ruptured tubal sac may also force itself into the broad ligament, in other words it will form a hsemaftoma. Nevertheless, Taylor teaches that hannatoma of the broad ligament is only in the minority of cases due to tubal pregnancy [loc. cit.., p. 65). I am of opinion that liasmatoma is more frequently the result of extra-uterine pregnancy. In the case which Gustav Klein, “ Operiren oder Nicht-Operiren bei Eileiter-Schwanger- schaft und Haematoeele ? ” ‘ Monataselir. fur Geb. u. Gyn.,’ December, 1903, p. 897. The conflicting evidence of Klein and Gossmann deserved consideration. * “ A Contribution towards the Study of the Natural History of Tubal Gestation, illustrated by a Series of Seventy-five Original Cases,” ‘ Journ. of Obstet. and Gyn. of Brit. Empire/ vol. i, p. 585. t Gustav Klein, loc. cit.