File:The diagnosis and treatment of diseases of women (1907) (14784463415).jpg

Identifier: diagnosistreatmecros (find matches)
Title: The diagnosis and treatment of diseases of women
Year: 1907 (1900s)
Authors: Crossen, Harry Sturgeon, 1869-
Subjects: Genital Diseases, Female Gynecology Gynecology Women Generative organs, Female
Publisher: St. Louis : Mosby
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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in that region, is that the colon 168 GYNECOLOGIC DIAGNOSIS resonance can be made out in front of it. When the growth is large, the colonmay be fiattentd out by compression between the tumor and the abdominal wall,and in that case no colon resonance would be obtained in the ordinary examina-tion. But the colon resonance can be easily brought out by inflation of the colonwith air, introduced through a rectal tube by means of the ordinary double-bulb oran atomizer bulb. This point is well illustrated by the following case. Mrs. M.was sent to me for operation for a fibroid tumor of the uterus. There was a largemass lying in the left lower abdomen, easily palpable and extending to the uterus.Superficially it prevented the appearance of a pediculated subperitoneal fibroid.On deep palpation, however, this prominent mass was found to be connectedwith a deeper mass which extended up into the lumbar region. By manipula- Small intestine Descending colo erenal fasci:Peritoneini RctrOrenal fascia
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Fig. 205. A case of Peri-renal Lipoma—another form of Retroperitoneal Tumor. (Edward Reynolds—AniKiIs ofSurgery.) tion the whole mass could be displaced upward somewhat, sufficiently to show thatits point of origin was probably in the left lumbar region and not in the pelvis.When the tumor was displaced upward, the vaginal and abdominal fingers, in thevagino-abdominal examination, could be made to meet between the mass and theuterus, and no pedicle connecting the two could be felt. The diagnosis then laybetween a kidney tumor and an enlarged spleen. The palpable portion of themass did not have the characteristic shape of either the kidney or the spleen,but it approached nearer the shape of the spleen. There were no kidneysymptoms. Percussion showed dullness all over the mass (Fig. 202) ■— therewas no colon resonance. But the mass was more deeply placed than an enlargedspleen usually is, and the upper end seemed to extend directly into the kidneyregion. So I inflated the colon

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