On the diagnosis and treatment of a case of patient urachus / by William L. Reid, M.D. ... Physician for Diseases of Women, Glasgow Western Infirmary.

  • Reid, William Loudon, Dr.
Date:
[1899]
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Licence: Public Domain Mark

Credit: On the diagnosis and treatment of a case of patient urachus / by William L. Reid, M.D. ... Physician for Diseases of Women, Glasgow Western Infirmary. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    “ A very fine probe passes through some granulation tissue in the depression of the umbilicus downwards and backwards for three inches, that being the whole length of the probe; a No. 4 sound cannot be made to enter the sinus. “ P. V. cervix is high, split on the left side, eroded, but not ectropic. There is no evidence of a pelvic cellulitis, but the sound, passed easily to three inches, showed that the fundus, not quite fixed, was yet greatly restricted in its movements.” The above note is, I think, defective, inasmuch as it fails to state that the sound passed towards the right side as well as downwards and backwards; and this gave countenance to the belief expressed by one of the surgeons to the hospital, as well as by two or three other medical men who examined the case, that it was one of abscess in the region of the right ovary, and in which pus had found its way to the surface in this unusual locality. It was decided to examine the patient under chloroform. “ November 24th. To-day, under chloroform, Dr. Reid passed a long thin probe into the sinus opening at the umbilicus, and this, passing quite easily downwards along the abdominal wall, finally appeared externally at the urinary meatus.” I am afraid this is not strictly true. The instrument used was what is commonly called a post-mortem probe, 10 inches long, and it passed downwards with many hitches until its eve reached the umbilicus. A peculiarity, afterwards explained, was that the probe passed backwards as well as downwards, so that, near the pubis, it was so deep that it could not be felt through the anterior abdominal wall. I thought it had passed into the vagina, but, on examina- tion, I was astonished to find it projecting from the urethra. Then, for the first time, I recognized that I was dealing with a case of patent urachus. So far as I can find, there is no case on record in which the diagnosis was made by passing a sound from the umbilicus to the urethral orifice. Dr. Freer {Annals of Surgery, Vol. V., St. Louis, 1887) mentions a case where the diagnosis was made
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