Fibroid tumours of the uterus complicating pregnancy : a record of personal experience / by Charles J. Cullingworth.

  • Charles James Cullingworth
Date:
1901
Catalogue details

Licence: In copyright

Credit: Fibroid tumours of the uterus complicating pregnancy : a record of personal experience / by Charles J. Cullingworth. 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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    appearing beneath the left lower ribs. It rested on the muscles of the back to the left of the lumbar spine as the patient lay on her back^ but it did not cause bulging either in the flank or the loin. It could be tilted forward by the finger passed under the loin. There was resonance over the whole anterior aspect. The tumour was tender, but not painful. When the finger was placed on the cervix uteri, ]oer vaginavi, and the tumour was pushed upwards beneath the abdominal wall, no dragging sensation was imparted to the cervix, or other impulse given. The urine was free from albumen. The possibilities that occurred to my mind were tumour of the kidney, tumour of the ovary, and pedunculated sub- peritoneal fibroid. I thought the most likely diagnosis was renal sarcoma. Upon my advice Mr. Henry Morris was asked to see the case. He agreed with me as to the tumour being almost certainly retro-peritoneal and unconnected with the uterus. He thought it was either a renal tumour or a retro-peritoneal lipoma. Being asked my opinion as to treat- ment, I told him that I thought the tumour ought to be removed without delay, leaving the pregnancy undisturbed. I did not think it would be wise to let the case go on without something being done, and to cut short the preg- nancy would be to leave the patient with the more serious operation still before her. In this view Mr. Morris entirely concurred. The patient and her husband having given their consent, Mr. Morris opened the abdomen on October 6th, 1897. The tumour proved tQ be a large pedunculated sub- peritoneal fibroid^ 4 lbs. in weight, lying behind and to the left of the uterus, and attached to the left cornu. The tumour was removed, and the patient made a good re- covery without interruption to her pregnancy. She was delivered by Dr. Dysart McCaw, instrumentally, of a living male child, 10 lbs. in weight, on February 24th, 1898, and both she and the child did well. The following case will illustrate my views as to the conditions under which alone marriage should be sanctioned in the case of patients with fibroid tumours of the uterus of such a kind as to make pregnancy dangerous.