Fibroma of the ovarian ligament weighing over sixteen pounds : removal, recovery.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927.
Date:
[1889]
Catalogue details

Licence: Public Domain Mark

Credit: Fibroma of the ovarian ligament weighing over sixteen pounds : removal, recovery. 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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    s t'fZl , {(PQh Jt* flinty FIBROMA OF THE OVARIAN LIGAMENT WEIGHING OVER SIXTEEN POUNDS: REMOVAL: RECOVERY. Thb fibro-muscular band, known as the ovarian ligament, which connects the ovary to the uterus, is rarely the seat of a tumour. In cases of multiple interstitial fibro-myoma of the uterus, a small fibroid is occasionally found in that ligament. Recently, however, I have had under my care a case where a solid tumour, weigh- ing 16 lbs. 4 02., was developed in the right ovarian liga- ment. This tumour I successfully removed, together with both ovaries. S. G., aged 32, nine years a widow, and the mother of one child, 9 years old, came under my care last April; she lived at Tebworth, Bedfordshire, and was a patient of Dr. Waugh, of Toddington. She had first observed that her abdomen was growing larger more than two years ago; soon afterwards she was seized with severe pain over the right side of the swelling. The abdomen had in- creased in size very rapidly during the last few months before ad- mission. I found the abdomen greatly distended by an elastic tumour, which reached from the pubes to the epigastrium, and extended towards the flanks, especially on the right side. The girth at the umbilicus was 41 inches. The cervix uteri was low in the pelvis; the sound passed 3^ inches forward. The uterus was pressed down by the tumour, with which it was clearly not continuous, but its movements were impaired. The catamenia were regular, with moderate “ show.” On May 4th, 1889,1 operated on the patient at the Samaritan Hospital, assisted by Mr. J. Malcolm; chloroform being given by Dr. Rutherfoord. I made a free incision, about 3 inches long, at once, and exposed a large tumour; its surface was fasciculated, greyish-brown and gelatinous-looking, as in some adenomatous multilocular cysts. No fluid escaped on tapping. 1 endeavoured to reduce its bulk by thrusting my hand into its interior, but its substance was very tough, and I could not find any septa to break down; very little blood was lost during the attempt. I prolonged the abdominal incision nearly three inches above the umbilicus, and found a strong omental adhesion on the uppermost part of the tumour; the vessels in the omentum were very large, and required careful ligature. To the right and left of the tumour were omen- tal and parietal adhesions; one was very troublesome to secure. I transfixed it with No. 2 silk, but the ligature slipped, and fresh transfixion was necessary later on. Then the great tumour could be drawn out of the abdominal wound, some lobulated masses which fitted into the right iliac fossa projecting from its right side. Two appendices epiploic® of the sigmoid flexure adhered to