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
Catalogue details

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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    The patient's condition at this stage was very serious, and as the precise source of the haemorrhage could not be determined, I tied both ovarian vessels, turned down an anterior flap of peritoneum from the lower part of the uterus, secured the uterine vessels, and amputated the uterus through the upper part of the cervix. That organ then came away with both tubes and ovaries, and with the great dome of membrane which had capped the mass of clot. That displaced membrane consisted of the opened- up broad ligament and peritoneum which had once formed Douglas’s pouch. The pelvis was drained with iodoform gauze and the abdominal wound closed except at its lower angle. Over one pint of saline fluid was injected under the breast during the operation, and a saline enema was administered. After the abdominal wound had been closed a pint and a half of saline fluid was injected into the left median basilic vein. When the patient was put back to bed her condition was very unfavourable. At the end of three-quarters of an hour she seemed a little stronger, though there was no pulse at the wrist. Brandy and digitalis were given ; enemata and hot water could not lie retained. At noon the temperature had risen to 105‘2° and there was a rigor. I observed marked facial spasms which lasted for several minutes. Half an hour later the pulse could be felt. By 6 p.m., after free administration of digitalis and brandy, the temperature had fallen to 103°; the pulse was 150, but distinct and regular. At 10 p.m. temperature 101-0°, pulse 138, and the patient took barley water. The absence of vomiting was remarkable. Twenty-four hours after the operation, the patient seemed much stronger and flatus passed naturally. I l’emoved the gauze, and little or no oozing followed ; a rubber tube was left in the lower angle of the wound for a few days. The cavity was washed out with antiseptic solutions for about four weeks, some sloughy tissue coming away. The anaemia was relieved by suitable