Three cases of early tubal gestation successfully treated by abdominal section : two of the cases after, and one before, rupture of the tube / by Charles J. Cullingworth.

  • Cullingworth, Charles J. (Charles James), 1841-1908.
Date:
[1892?]
Catalogue details

Licence: Public Domain Mark

Credit: Three cases of early tubal gestation successfully treated by abdominal section : two of the cases after, and one before, rupture of the tube / by Charles J. Cullingworth. 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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    Noon 100° 26tl), 8 a.m. 101° 4.30 p.m. 101-8 4 p.m. 100-8 8 p.m. . 1012 Midn. . 100-2 Midn. . 99-8 27tb, 4 a.m. . 100-6 4 a.m. 100 8 a.m. . 102-8 Abdominal section was performed at 9.30 a.m. June 27th, Mr. Osburn assisting. An incision, three and a balf inches in length, was made half way between the umbilicus and the symphysis pubis. On opening the peritoneum, there was a gush of thin dark blood, suggesting a wound of a large vein. No vein could be detected, and it soon became apparent that the flow came from within the peritoneal cavity. The opening was enlarged and blood poui'ed out freely. On introducing the hand, a large, tense, oblong tumour was felt extending behind the uterus and right broad ligament; this was recognised as the Fallopian tube, occluded, dis- tended with fluid, and attached to the parts around by recent and easily separated adhesions. The tube was enucleated without difficulty, and removed along with the normal right ovary. The contents of the distended tube proved to be a dark brown viscid fluid, consisting of mucus and altered blood. The left appendages were now examined and brought into view. The tube was distended in its central portion, and rupture had taken place into the peritoneal cavity. Through the opening, which was 1£ inches in length, the placenta was partially protruding. The placenta had a diameter of inches, and attached to its margin was the umbilical cord, 2 inches in length and one line in diameter. A small foetus, 2^ inches long, attached to the other end of the cord, was lying in the abdominal cavity, in front of the intestines. All these parts gave off an offensive smell of commencing decomposition. There was no evidence of general peritonitis. The anesthetist now announced that the patient was seri- ously collapsed, and the operation was concluded with all possible speed. The left broad ligament was transfixed, and the tube tied off and removed. The lower portion of the omentum, being thickened, and having blood-clot firmly adherent to it along its whole length, was tied in sections and removed.