Six cases of laparotomy / by John H. Packard.

  • John Hooker Packard
Date:
[1890]
Catalogue details

Licence: Public Domain Mark

Credit: Six cases of laparotomy / by John H. Packard. 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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    By JOHN H. PACKARD, M.D. [Reiul before the Philadelphia County Medical Society, February 26, 1890 ] The clinical histories to -which I shall ask the attention of the Society this evening have seemed to me to present features of suffi- cient interest to warrant their being placed upon record. My own comments upon them will be very brief, but I shall be glad if the facts stated should elicit expressions of opinion on the part of others : Case I. was one in which the operation was exploratory. The patient, May 0., set. twenty-three, was admitted into the Pennsylvania Hospital October 16, 1889. Menstruation began at fourteen, and was always profuse and painful, often lasting ten days. She generally had leucorrhoea between times, the discharge being sometimes thick and yellow. Married at eighteen, she had a difficult but not abnormal labor one year afterward, getting up on the eleventh day, and nursing the child until it was eighteen months old. Her menses came on about six weeks after her confinement, and have recurred regularly since. Three years ago she began to feel pain in the right ovarian region, and detected a small swelling there. The pain and tenderness extended over most of the abdomen, but in less degree. There had been a steady growth in the tumor, which seemed to be about the size of a small orange. For about six months she had been failing in general health, losing over twenty pounds in weight. Her appetite was capricious, and her sleep much disturbed. An exploratory laparotomy was decided upon, and performed October 21st. The abdomen being opened in the median line, the uterus and appendages were found to be normal, except that the left ovary was studded with small cysts. The tumor was found to be connected with the abdominal wall only, like a hemisphere attached by its flat side. The median opening was closed, the peritoneum being sewed separately with fine catgut. Next, the tumor was removed through an incision made parallel to Poupart’s ligament. In dissecting it away, the peritoneum was again opened, and this wound was also sutured with fine catgut. The patient reacted well from the ether; temperature in the evening 100°. She complained of severe abdominal pain. On the 22d the menstrual flow reappeared, and the pain passed away. On the 30th, the ninth day, the dressings were changed, and both wounds