Large cystic myoma of uterus of over twelve years' duration removed by enucleation : recovery : with notes on cystic 'fibroids' / by Alban Doran.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Large cystic myoma of uterus of over twelve years' duration removed by enucleation : recovery : with notes on cystic 'fibroids' / 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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    for a week with severe pains in the abdomen and lumbar region. The abdomen was then muck distended. She could no longer work in the laundry, but was able to sit up and ply her needle till admission, when her health was failing rapidly. She was rather tall and somewhat emaciated. She lay on her back in bed, feeling uneasy when sitting up or lying on one side. The abdomen was extremely distended, especially towards the left; the superficial veins were dilated, the integuments free from oedema. The girth at the umbilical level was 44| inches; the distance from the ensiform cartilage to the umbilicus 11 inches; from the umbilicus to the symphysis pubis 14^ inches. The disten- sion was due to a tumour which reached to and pushed forward the ensiform cartilage. There was resonance in the left loin, but not in the right. The lower part of the tumour was very prominent and fluctuated separately from the rest, from which it appeared to be divided by a deep groove. Over the upper and lateral parts was distinct fluctuation. On vaginal examination the cervix could be felt rather high up and far back in the pelvis. The sound passed three inches forward and to the right; it could be moved somewhat forwards, but in no other direction. The tumour descended into Douglas’s pouch and the left fornix, and on the other hand extended anteriorly downwards in front of the sound. A mucous polypus, about one inch in length, projected from the os. The period, regular till a year before admission, had not been seen for six months. The average daily excretion of urine, independent of what passed during defascation, was 35 ounces during the first week in hospital, the sp. gr. 1020. There was a trace of albumen. The tempera- ture was normal; the pulse 100, hard, small volume. The diagnosis was very uncertain ; there had been no menorrhagia, and I have seen many large ovarian tumours of ten or twelve years’ standing present similar features, physical and clinical. Hence some of my colleagues,
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