Case of tubarian gestation, with rupture of the cyst, containing the embryo, and fatal hemorrhage into the peritoneum / [Robert Mortimer Glover].

  • Glover, Robert Mortimer, 1816-1859
Date:
1842]
Catalogue details

Licence: Public Domain Mark

Credit: Case of tubarian gestation, with rupture of the cyst, containing the embryo, and fatal hemorrhage into the peritoneum / [Robert Mortimer Glover]. Source: Wellcome Collection.

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    9, pulse was scarcely perceptible, and apparently but little quicken¬ ed, about 80; the tongue continued clean. An examination per vaginam was again made, and the lips of the uterus were found less tumefied. A draught of laudanum and ether was ordered. I saw the case in consultation with Mr Dixon shortly before eight o’clock. Previously to this she had severe vomiting, a wa¬ tery fluid being ejected from the stomach with great force. Her state was generally as has just been described. The abdomen was everywhere painful on pressure, especially inferiorly, where it had a doughy feel. Superiorly, there was some degree of tym¬ panitis. Great pain was especially felt over the iliac fossse. There was now no discharge from the vagina. The pupils were dilated, and the patient in a state of partial stupor. Amidst the difficulties with which the case was invested, we de¬ termined to treat it as for peritonitis. Turpentine injections were ordered, and sixteen leeches to the abdomen over the seat of pain; a bolus of twelve grains of camphor, and two of opium were directed to be taken immediately. She continued in the same state during the night. At 12 o’clock she had a draught containing nitrous ether and ammo¬ nia; and this was repeated several times during the night. In the night-time she had three turpentine injections, and her bowels were freely moved. Towards morning there was repeated vomit¬ ing, and again a watery fluid was ejected with great force. The symptoms of depression continued to augment, she lay during the next day in a state of insensibility, and died at 6 p.m. Autopsy.—An inspection of the body was made forty hours after death by Mr Dixon and myself. No external sign of pregnancy was observed. On opening the peritoneum, a large clot was perceptible, occu¬ pying the space from the umbilicus in front downwards into the pelvis. The transverse colon distended with flatus, exhibited several patches of inflammation on its peritoneal coat; and on opening the intestine, the mucous membrane was observed in some parts reddened opposite these external marks. The same was observed in many parts of the small intestines. The pelvis and iliac regions, and posterior part of the abdomen contained a quantity of dark-coloured fluid blood, which we estimated at two pounds; while the clot we conceived might weigh three-quarters of a pound. The peritoneum lining the inferior and posterior parts of the abdomen, and the pelvis, exhibited an intense red¬ ness, which appeared to arise partly from increased vascularity, but chiefly from coloration by contact with the effused blood. A careful examination of the interior of the peritoneum was made by the hand, and with the light of a candle, with the view of detecting some ruptured vessel, the cause of the hemorrhage; but in vain. However, a sac of the size of a walnut was found