Cases of ovariotomy : with a table of sixty-five cases / by Thomas Keith.

  • Thomas Keith
Date:
1867
Catalogue details

Licence: Public Domain Mark

Credit: Cases of ovariotomy : with a table of sixty-five cases / by Thomas Keith. Source: Wellcome Collection.

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    Case LV.—Multilocular Ovarian Tumour. Ovariotomy. Recovery. Mrs M-, aged 35, came to me on the 15th of March 1867, on account of an ovarian tumour which had been observed after her first confinement, six months before. During her pregnancy she had suffered very much from distention. The cyst was multilocu¬ lar, and there was general coarse crepitus over the right side. The measurement at the umbilicus was 40 inches. The uterus was central, normal, and movable. She was very thin, but her general health was fairly good. A favourable prognosis was given, and ovariotomy was per¬ formed on the 18th of March. One large cyst was tapped, and the rest of the tumour broken up. There was only one patch of parietal adhesion over the edges of the ribs on the left side. It was extremely firm, and in separating it, the serous covering of the cyst was torn off and remained. It felt hard and rough, as if con¬ taining some bony or earthy matter. The haemorrhage from this was so free that, after tying several bleeding points, it was neces¬ sary to pass a needle under it, and include in three portions the whole of the bleeding surface, cutting the ligatures off short. The pedicle was secured by a clamp two inches from the right side of the uterus. She vomited some frothy mucus during etherization, but there was no after vomiting. She had a red dry tongue, a good deal of flatulent distention and highly concentrated urine for the first three days. On the fourth evening after operation, the pulse was only 66. She had, however, a restless night, and in the morning the pulse had risen to 100. By the sixth day, the pulse was 120, respirations 32 ; temperature 102T ; and there was some fulness of Douglas’s space. This state of matters continued for some days. I thought of puncturing behind the uterus, but as the tension did not increase, and the pulse began to fall, I waited. On the eleventh day, several ounces of matter were discharged from the bowel; the swelling in Douglas’s space disappeared; she recovered rapidly, and went home twenty-eight days after operation. Case LYI.—Nearly Unilocular Cyst. Ovariotomy. Recovery. In October 1865, I saw a lady fifty-eight years of age with a single unattached cyst of the right ovary filling the abdomen. She was of a nervo-bilious temperament, thin, but fairly healthy-look- ing. Some time before, there had been great oedema of the lower limbs, which still continued to a certain extent. She had for long suffered from headache and various neuralgic pains, with general irritation of the mucous surfaces. A very favourable prognosis was given, but no interference was then recommended, as the tumour had been of slow growth, and had hitherto given rise to little discomfort.