File:Interstate medical journal (1919) (14760932951).jpg

Identifier: interstatemedica2619unse (find matches)
Title: Interstate medical journal
Year: 1919 (1910s)
Authors:
Subjects: Medicine
Publisher: St. Louis, : Interstate Medical Journal
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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in-cision would not suffice. The day before the operation the abdominalwall was punctured with a trocar at three points. The first removeda very thick muddy fluid, and the other two a thick clear fluid.Evidently the cyst was multilocular. About 8 gallons of fluid wereremoved, which reduced the bulk of the tumor and made it a littleeasier to handle. Operation.—September 19, 1917. A hypodermic of scopolamin 104 INTERSTATE MEDICAL JOURNAL 1/100 gr. and morphine 1/6 gr. was administered one hour beforethe operation in addition to her habitual dose of morphine. Theanesthetic was gas and oxygen preliminary to ether by the openmethod. A transverse incision was made from the crest of oneilium to the other through the skin and fat (Fig. 2). The skinand fat were dissected from the aponeurosis below the incision for4 inches. The attenuated aponeurosis, muscle, and peritoneum werethen cut transversely (see dotted line in Fig. 2). The tumor was found to be a large multilocular cyst of the right
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Fig-. 3.—After operation. Partial front view. ovary. The pedicle was cut and ligated, adhesions separated, andthe tumor removed. The remaining pelvic organs seemed normaland were left. The posterior portion of the pendulous abdominalwall was cut transversely through all its layers, and this removedall excess of abdominal wall. The lower edge of the incision wassutured to the upper edge of skin and fat, thus overlapping frombelow upward for 4 inches the aponeurotic, muscular, and peri- Collins: Large Ovarian Cyst 105 tonitic layers. The upper edge of the aponeurotic, muscular, andperitonitic layers were sutured to the under surface of the lowerflap with tannated catgut, and the lower edge was sutured to theanterior surface of the upper flap in the same way. The dark color of the skin of the lower part of the abdominalwall seen in Fig. 3 was caused by pigmentation. Before the tumorand pendulous abdomen were removed this portion of the skin cov-ered a portion of the posterior wall of t

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