Annals of surgery . causing the swelling todiminish to such an extent that care was required in its detection. At various times she had consulted physicians in referenceto the condition, but aside from prescribing various washesand ointments, no treatment or diagnosis was offered. She was finally referred to me, and an examination revealedthe following conditions: Patient well preserved and activefor her age. The abdomen was very fat, and a tumor, cocoanutsize, presented in the median line between the umbilicus andsymphysis pubis. The mass could be raised with the abdominalwall, and was appare
Annals of surgery . causing the swelling todiminish to such an extent that care was required in its detection. At various times she had consulted physicians in referenceto the condition, but aside from prescribing various washesand ointments, no treatment or diagnosis was offered. She was finally referred to me, and an examination revealedthe following conditions: Patient well preserved and activefor her age. The abdomen was very fat, and a tumor, cocoanutsize, presented in the median line between the umbilicus andsymphysis pubis. The mass could be raised with the abdominalwall, and was apparently attached thereto. There was a copious discharge of foul-smelling pus fromthe umbilicus, and an eight-inch probe passed into the sinusfailed to reach the lower wall of the sack. The temperature 532 WALTER RUPERT WEISER. was ioi°; pulse loo. She volunteered the information that itwas no worse than usual, but she was not feeling so well generallyand there had been, during the past month, very DOTTED LINLREPRESENTSURACHUS VCY5T V/ALL UN01 LA TEDf— PORTION US BLADDEf^ Fig. I.—Cyst of Urach CYSTS OF THE URACHUS. ^33 Under ether anaesthesia I excised the umbiUcus and un-healthy skin surrounding it, and, incising down through twoinches of fat, came upon a bulging mass extending from theumbilicus as far down as I could feel toward the symphysispubis. (Fig. I.) This I tapped, and evacuated about five ouncesof horribly fetid pus, followed by a calculus weighing 70 with the finger demonstrated the fact that the cysthad a thick and indurated wall and dipped well down to thepelvis. Up to this point in the operation I had not opened theperitoneal cavity. I now washed out the sac and packed itwith gauze and entered the peritoneal cavity above the locationof the tumor. To my surprise I found the mass densely adherentto the intestines posteriorly, and, passing my hand down into thepelvis on the outside of the cyst, discovered it to be
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
