Eight cases of thyroid cysts and adenomata, treated by enucleation / by Charters J. Symonds.

  • Symonds, Charters James, 1852-1932.
Date:
[1889]
Catalogue details

Licence: Public Domain Mark

Credit: Eight cases of thyroid cysts and adenomata, treated by enucleation / by Charters J. Symonds. 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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    Reprinted from Vol. XXIII of the * Clinical Society’s Transactions.’’] §=•*-*' ■ .X I > Eight cases ofyThyroid Cysts and Adenomata, treated by enucleation. By Charters J. SymondA Read- December 13, 1889. THE following cases are offered as a contribution to the surgery of the thyroid gland. They are given in chrono- logical order, to indicate the improvement in the method of operation. Case 1. Adenoma of thyroid: extirpation of entire gland. —Thomas B., set. 29, was admitted into CuyJs Hospital May 17, 1883. Just before Christmas, 1882, he noticed a pain in his neck, which increased on swallowing; in February, 1883, a lump was noticed above the sternum, and in March he was obliged to give up work on account of the inconvenience on stooping. He was admitted under Dr. Mahomed into Philip Ward with dysphagia, and a tumour above and behind the sternum. It varied in size, but was no smaller when discharged on Api’il 21. When admitted under Mr. Symonds there was a firm tumour in the median line reaching two inches above the sternum, the lower end lying beneath the bone. It extended a little to the left side under the sterno-mastoid. He com- plained of pain during swallowing, when the tumour moved up and down with the thyroid. It was rounded, elastic, appa- rently solid. When working, the tumour compressed the trachea and produced dyspnoea. May 29.—A median incision was made from the centre of the thyroid cartilage to the sternum, the tumour quickly exposed and brought forward with the thyroid lobes ; it was attached to the isthmus. After ligaturing several small vessels the tumour was detached from the lobes. A wide irregular bleed- ing surface was left, and as this seemed part of the tumour the entire gland was removed. Commencing on the right side the lower border was raised, and the inferior thyroid arteries and veins ligatured, the former with silk, the latter with gut; then the superior was ligatured and divided. Next the isthmus was dissected off the trachea, the left lobe attacked in the same way, and the whole removed. Very little blood was lost, neither the carotid sheath nor the laryngeal