Vaginal ovariotomy / by Clifton E. Wing.

  • Wing, Clifton Ellis, 1848-1911.
Date:
1876
Catalogue details

Licence: Public Domain Mark

Credit: Vaginal ovariotomy / by Clifton E. Wing. 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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    lost their characteristic shape and had become irregularly crenated. The surfaces of many showed a few spots not unlike small globules of fat[?]. In addition were seen numerous granular cells in various stages of fatty degeneration, varying in size from that of a white corpuscle to double that size. Hsematin crystals; no others. Diagnosis of fluid, old haemorrhagic effusion.” The tapping was not followed by any symptoms. March 80th. The tumor remaining the same, the aspirator was again used, and this time several ounces of the same fluid were removed, and the mass much diminished in size. This second tapping was not fol- lowed by improvement; on the contrary, some time afterwards the patient began having occasional slight chills followed by fever, nausea, and headaches; in fact, a mild septicaemia. She continued to lose strength and appetite, though not confined to bed. When next seen, April 19th, an examination showed the mass be- hind the uterus to be as large as ever, and more tense and cyst-like. Upon passing an exploring needle from the vagina, as before, a few drops of exceedingly offensive matter escaped. It was evident that the fluid must be thoroughly evacuated, whether it came from an old hae- matocele or from a haemorrhagic ovarian cyst, one of which seemed to be present. With the aid of Sims’s speculum and position, the parts being well drawn down towards the vulva with tenacula, and care being taken to avoid w'ounding the rectum, an opening was made through the upper part of the vagina and the peritoneum into Douglas’s cul-de-sac. Pass- ing my finger through this I distinctly made out a small ovarian cyst, about the size of an orange, fixed in the cul-de-sac by some loose adhe- sions which easily gave way before my finger. The opening having been enlarged, the cyst was seized with strong forceps, opened and evacuated, then twisted to diminish its size, and pulled through into the vagina. There was no proper pedicle, but the uterus, tipping back- ward, allowed the broad ligament with the Fallopian tube to come wrell into the vagina. I intended here to apply a ligature and cut away the cyst, but Dr. Warner, in making a digital examination, finding the attachments loose, attempted enucleation with his finger, succeeded in separating the tumor, and brought it awray. There Was some bleeding, which soon ceased entirely, and as the uterus went forward the broad ligament slipped back into the abdomi- nal cavity. No ligature whatever was used, but, a coil of small intes- tine appearing at the opening, I inserted three silk sutures and closed the wound sufficiently to prevent hernia, but left room to pass a cathe- ter, should there be any collection to wash out. The patient was then put to bed. April 20th. Patient came out of the ether well, had no shock, and