Transactions of the American Association of Obstetricians and Gynecologists for the year ... . November when she first consultedDr. Brattain who discovered a mass in the right iliac fossa andsent her to her home and bed. In spite of his advice she calledpersonally at his office the following day and he recommendedoperation. After considerable difficulty she was persuaded toaccept his recommendation and came to the city where shewalked into the hospital. On opening the abdomen the condition shown in Fig. i pre- APPENDICITIS DURING PREGNANCY. 575 sented. The omentum was firmly adherent over the
Transactions of the American Association of Obstetricians and Gynecologists for the year ... . November when she first consultedDr. Brattain who discovered a mass in the right iliac fossa andsent her to her home and bed. In spite of his advice she calledpersonally at his office the following day and he recommendedoperation. After considerable difficulty she was persuaded toaccept his recommendation and came to the city where shewalked into the hospital. On opening the abdomen the condition shown in Fig. i pre- APPENDICITIS DURING PREGNANCY. 575 sented. The omentum was firmly adherent over the mass andwas finally ligated and divided when it was seen that the masswas made up of an enormous prolongation of the uterus on whichwas cemented the appendix, the ileum and cecum. The adhe-sions were the strongest I have ever met with. A large part ofthe dissection had to be made by the knife. While separatingthe small bowel from the uterus about 2 ounces of thick creamypus escaped on the packing. It was very hard to identifystructure and in separating the cecum from the uterine diverticu-. FiG. 2.—Omentum ligated; appendix turned back exposing ulcer. Dotted lineindicates parts severed. lum a rent was made in what was thought at first to be theileum but subsequently proved to be the base of the the appendix was amputated the amputation was made onthe cecal side of the rent. Upon removing the omentum, bowel and appendix from thediverticulum a large ragged ulcer was seen, as indicated in Fig. whole diverticulum was then removed by an elipticalincision and the incision closed leaving an appearance much asshown in Fig. 3. In removing the diverticulum the right tube was severedfrom its uterine attachment and allowed to remain because it 576 B U D D VAN S W E RIN G E N, had escaped involvement its position being behind and below themass. A large gauze pack was introduced over the uterineincision and around the appendiceal stump. Her convalescence was perfectly s
Size: 1477px × 1691px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bo, bookcentury1900, booksubjectgynecology, booksubjectobstetrics
