Second and third series of twenty-five cases of completed ovariotomy / by G. Granville Bantock.

  • Bantock, George Granville, 1837-1913.
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: Second and third series of twenty-five cases of completed ovariotomy / by G. Granville Bantock. 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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    patient for three days. By that time, the urine had lost all trace of blood, and was clear and normal. On the fourth day, the temperature began to rise above 99°. She was sick, and, to my surprise, the fluid from the tube increased in quantity. I thought I had met with an in- stance of irritation of the peritoneum by the tube, and as the fluid was now quite pale, I removed it, substituting a small piece of India- rubber tubing, to prevent too early closure of the opening. There was no perceptible distension of the abdomen, and I hoped the sickness was due to some other cause than obstruction. However, she grew worse, and died on the sixth day, with undoubted symptoms of obstruc- tion of some portion of the small intestine. The post mortem examination showed that there was not a trace of peritonitis along the whole course of the tube; the small intestines were moderately distended, and the ends quite free; the torn parts between the uterus and symphysis pubis were well united, though now easily broken down. On drawing up the intestines out of Douglas’s pouch, there was brought to view about the last foot of the ileum, firmly con- tracted and cord-like. The constriction began at a point where a knuckle of intestine was caught and bound by a patch of what looked like slightly stained lymph, and which I believe was nearly decolorised blood-clot. I now saw that, had I had the courage to open up the wound and search for the obstruction, nothing could have been easier than to undo it. But I was deterred from the attempt by feeling that any injury I might do by disturbing the uterus would be irreparable, and that, in trying to remove one source of evil, I might be inflicting a worse. Moreover, the passage of small quantities of flatus induced me to think that the obstruction would give way, and the absence of decided distension led me to temporise, and then delay, till it was too late. Now I would not have this mishap set down to the drainage-tube. Without it, the patient would not have had the remotest chance. A large quantity, more t,han half a pint, of blood more or less coagulated came away through the tube, and my explanation is that a small clot had become attached to the intestine, which lay at the bottom of the pouch and prevented its uncoiling. There was no true constriction. More recently, Dr. G. Eustache of Lille has sent me the particulars of a case in which he wounded the bladder in making the abdominal incision. His patient recovered. Two drainage-tubes were used {Journal des Sciences Medicates de Lille; and British Medical Journal, October 25th, 1879). No. 41 was interesting from the fact that, before the operation, the urine contained a very large quantity of albumen—one-third. Other- wise it was normal, i.e., specific gravity was normal and the quantity average in amount. As the patient looked healthy, I had no hesitation in operating, as I believed the albumen was due to pressure, and not to organic disease. Dr. Marion Sims was amongst the spectators. The
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