OVARIAN TUMOUR: OPERATION?DEATH. By Surg.-Lieut.-Col. 11. P. Esmonde

A Nair

girl,

White, f.r.c.s.i.

32 years of age, with

a

large

ovarian tumour, which had been twice tapped, was operated on by me recently in the usual way. There were no adhesions in front, and the case I used a large Nelaton's was a promising one. vulsellum trochar which acted very badly. Not only did the fluid escape at the seat of punctures, but the claws on either side broke away from

the sac, and there was much difficulty in keepthe fluid from entering the abdominal cavity. I would never again use this instrument. The fluid having been evacuated, I passed my hand into the abdomen, as the sac did not come out readily, and found an adhesion 011 the left side, and what I first took to be the kidney of the right side also firmly adhered. I drew out the left adhesion, and, having passed an eyed aneurism needle with a carbolized gut ligature, I divided the latter, making two ligatures, and cut the adhesion which was the broad ligament. I now again passed my hand into the abdomen aud found the hard substance I took for the kidney to be quite movable, and, on drawing it to the surface, I found it was merely a cyst, and that the tumour had no pedicle or attachment: the sac was attached to the loose hard mass with several small round smooth cysts, which I readily lifted out, and, having put on a double ligature to the small remaining fibres that kept the mass from being removed, I finished the operation as usual. The patient, who had been operated on under ether, recovered from the effects of the operation, and expressed her pleasure to her friends at what had been done, and was cheerful and hopeful. This Was about About one o'clock she suddenly be10 a.m. and showed the sign of shock, blanched, came aud died before anything could be done. A yost-mortem examination showed a couple of clots in the abdomen, aud one of the ligatures that had been put on the broad ligament loose. IIow it slipped I cannot imagine, but this accident caused the woman's death, as, in her weak condition, she could not bear the loss of the small quantity of blood that escaped, audshe died The from hajmorrhage and secondary shock. caseis of interest from the position the sac grew from, there being practically no pedicle, aud Had from the accideut of a ligature slipping. it not been for this accident, the patient would,

ing

no

doubt, have made

a

good recovery.

Ovarian Tumour: Operation-Death.

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