Lectures on ectopic pregnancy and pelvic haematocele / by Lawson Tait, F.R.C.S., Edin., & Eng., LL.D.
- Lawson Tait
- Date:
- 1888
Licence: Public Domain Mark
Credit: Lectures on ectopic pregnancy and pelvic haematocele / by Lawson Tait, F.R.C.S., Edin., & Eng., LL.D. Source: Wellcome Collection.
Provider: This material has been provided by University of Bristol Library. The original may be consulted at University of Bristol Library.
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![beccaiise it is a fatal case of hcemorrliage from the Fallopian tube in a young woman, aged twenty-two, due apparently to measles. On post-mortem examination hiemorrliage was found to have proceeded from the left Fallopian tube, which was distended to the size of tlie index finger, and contained about two ounces of blood, partly fluid, partly coagulated, and through the abdominal orifice as much as sixteen ounces of blood had escaped into the pelvis. These samples of hasmatocele occurring in rubeola, scarlatina and variola, demonstrate that this accident may occur in any severe fever. Finally, I wish to refer to a case originally contributed to the London and Edinhurgh Monthly Journal for 1841, because it establishes Ijeyond all douljt, that fatal luTuiorrhage can occur from the Fallopian tube into tlie peritoneum, under circumstances where the occurrence of rupture of the tube by an ovum is out of the question. An illustration of the tube is given. A large cpiantity of blood was effused into the abdomen and pelvis, mostly coagulated but partly fluid. At first it was impossible to say whence all this blood came, but on examining the pelvic viscera solid coagula were olDserved protruding from the open orifices of the Fallopian tubes. The tubes themselves were filled with blood and distended at a short distance from the uterus up to the distal extremity. The condition of the parts is very well shown in the accompanying sketch, which represents the serious state of one of the tubes and the appearance of tlie clot attached ; tlie latter has a sort of lobulated appearance produced by the constrictions exerted upon it in its passage along the tube. The other tube was the same. The greater part of the blood found in the pelvis escaped from the tubes no doubt in a fluid state, but that which was attached to the tubes was coagulated before it left the canal, as is evident from its shape. Concerning the prognosis of such cases Goupil says: It is but too true, I fear that we are authorised in saying, that all the cases of intra-peritoneal heicmorrhage arising from extra-uterine pregnancy, end in death—in fact all the cases that I have quoted have terminated in death ; generally it has taken place in a few hours or days, and though death has been delayed for six months (as in the case already quoted) it is wholly exceptional. This was absolutely true in my own experience till I was emboldened—shall I say till I was shamed by Mr. Hallwrights case, into opening the abdomen and saving their lives. We come to the following conclusions: That in the great majority of cases of extra-peritoneal luvmatocele, even when due to ectopic pregnancy, the disease may generally be left alone, being ]-arely fatal, and that it is to be interfered with only when suppuration or extreme haemorrhage has occurred. That, on the contrary, iutra-peritoneal hematocele is fatal with such](https://iiif.wellcomecollection.org/image/b21448048_0044.jp2/full/800%2C/0/default.jpg)
