Two cases of uterus septus unicollis, both associated with fibromyoma, and one also with haematosalpinx / by Alban Doran and Cuthbert Lockyer.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927.
Date:
1905
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Licence: In copyright

Credit: Two cases of uterus septus unicollis, both associated with fibromyoma, and one also with haematosalpinx / by Alban Doran and Cuthbert Lockyer. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    back of the tumour, but were easily detached. The ovarian and round ligament arteries were secured, then an anterior flap was made from the peritoneum. A smaller flap was cut from the posterior wall of the uterus, and the uterine arteries, not easily reached, were ligatured, and the uterus amputated above the cervix. The relations of the round and ovarian ligaments and Fallopian tubes to the uterus were seen to be normal, so that no abnormality was suspected. After the malformation of the uterus had been detected, the patient was examined and found to be free from any trace of polydactyly, hare lip or cleft palate. Malformations have been detected far from the genito-urinary tract in subjects with uterus bicornis. The patient recovered quickly and was in good health ten months after the operation. The parts removed, which weighed a pound and a half, were sent to Dr. Cuthbert Lockyer for examination. The specimen as removed by operation consisted of the uterus, together with the Fallopian tubes and ovaries of both sides. The uterus was nearly spherical in shape. The left tube formed a dark- blue sausage-shaped swelling which arched over the corresponding ovary. The distinctly enlarged left ovary was embraced on all sides, except below, by the distended Fallopian tube. The right tube and ovary were so densely matted together that only the proximal half-inch of the tube was clearly distinguishable. The uterus had been amputated at a. level of fths of an inch below the os internum. The lower third of its anterior surface was denuded of peritoneum, as was also the lower fourth of the posterior surface. On either side the uterus was bare of peritoneum below the attachments of the ovarian ligaments; these bare lateral surfaces were one inch wide and corresponded to the severed attachments of the broad ligaments. The peritoneum covering the upper two-thirds of the uterus was quite smooth; that on the posterior surface, especially at a point midway between the cornua, was roughened by adhesions, and a nodule of fat, like an appendix epiploica, was seen attached to the uterus at this spot. A probe passed into the single cervical canal could be made to run in two directions, right and left, but met with an obstruction in the middle line. On passing two probes they crossed one another just outside the cervical canal at an angle of 90°. The anterior uterine wall was laid open along each probe; two distinct cavities lined by mucous membrane were exposed by these incisions (Fig I.). These cavities communicated below at a point slightly above the level of the internal os. Above, they diverged towards the .entry of the Fallopian tubes. The septum between the diverging cavities corresponded to a large triangular segment of the uterus. This