Malignant newgrowth in childhood. I. Malignant disease of the uterus, ovary, and vagina in children / by William A. Edwards.

  • Edwards, William A. (William Aloysius), 1860-1933.
Date:
1909
Catalogue details

Licence: In copyright

Credit: Malignant newgrowth in childhood. I. Malignant disease of the uterus, ovary, and vagina in children / by William A. Edwards. 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.

    6/22 (page 4)
    which was caused by excessive vomiting when she was but thirteen years of age, and that of Karczewski,^ who saw a girl, aged thirteen ^ years, with complete procedentia developing gradually from carrying heavy burdens. Uterine displacement other than prolapse also occurs in very young children. Spencer® reports a case of retro- flexion of the uterus in a newborn child, and Berli,^ one of congenital displacement in the newborn. Carpenter,® who was one of the '' pioneers in the rectal examination of children, says that a uterus in a child, aged about two years, is an inch long and an inch broad at the fundus, the tubes about one and three-fourths inches, the right ovary five-eighths inch in length, and the left one-half inch in length, and each about one-sixth inch in diameter. The ovaries vary from five-sixteenths inch long by one-fourth inch broad in a child a few weeks old. The organs measure one and one-half inches by one- half inch in a child approaching puberty. Ovaries show some variations in size in children of similar ages. One ovary is not in- ticquently decidedly larger than its fellow. The Fallopian tubes for clinical purposes are about equal to the vas at a similar age, at their narrowest part, but they gradually enlarge as they pass along to the fimbriated extremity; in length they vary from a little over one inch to a little over three inches, according to age. As I have already stated, the two anatomical aids to the recogni- tion of these structures when examining by the rectum are the iliac arteries and the uterosacral ligaments. These ligaments, as Keating and I showed many years ago, form a curve surrounding the rectum in children, and when the finger is introduced and passed gently j upward their sharp edge is readily recognized. Following up this edge we surely come to both the tube and the ovary which can be outlined by pressing toward the bony wall of the pelvis. The H ureters are also palpable under the same guidance; in this way an impacted calculus has been detected in a tuberculous ureter in a y child. _ j; In examining children we must ever bear in mind that displace- ments of the ovaries and tubes into the inguinal or crural openings j are not extremely unusual, and if we find difliculty in locating them in the pelvis, these latter structures, the navel, the ischiadic, ] and obturator foramina should be examined; it is well also to re- ^ member that these prolapsed ovaries may be cystic and cause con- V siderable difliculty in diagnosis. ... ^ Diseases of the uterus, tubes, ovaries, and vagina in childhood ' are far more frequent than is generally supposed by those who have r not given special attention to the study of those diseases in the very young. Even as late as 1888 no less an authority than Lusk * Gaz. lek in Przegl. Chir., la Gynic., 1897, No. 1. “ Trans. Obstet. Soc., London, 1892-93, xxxiv, 25 to 28. » Univ. Med. Mag., 1893-94, vi, 185. • American System of Gynecology • Pediatrics, 1896, i, 481