Notes on so-called non-ovarian dermoid abdominal tumours / by Alban Doran.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: Notes on so-called non-ovarian dermoid abdominal tumours / by Alban Doran. 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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    on the right side, by an obscurely fluctuating tumour that extended towards, but not deeply into, the right flank ; it passed only an inch or two beyond the middle line to the left, and did not stretch the abdominal walls between the umbilicus and pubes after the manner of ovarian tumours. There was tympanitic resonance over the tumour, espe- cially towards the right side. The pelvic viscera were quite free from any sign of disease or implication with the tumour. On October 27th Dr. Bantock operated upon the patient. An incision was made along the outer border of the right rectus abdominis muscle. The surface of the tumour was exposed ; it appeared to be smooth, pale, and slightly shiny. On tapping with a Dieulafoy’s aspirator, a pint of fluid resembling pus was drawn off. The tumour was then found to be intimately connected with the great omentum and strongly adherent to the ascending meso- colon. It was not deemed judicious to lay it open before removal, lest the contents, which appeared to be purulent, should escape into the peritoneal cavity. After the tumour had been cut away, the right ovary was drawn up out of the pelvis and found to be quite healthy. The left was not searched for, as there were no direct grounds for suspicion at the time that the tumour might be ovarian. On examining the tumour after the operation it was found to be stuffed with hair, lubricated with seba- ceous material. There was no trace of either tube or pedicle. On the inner wall were some plates of bone and a tooth of very anomalous form, somewhat resembling a bicuspid, but tapering almost to a point at its edge. Both the operator and myself more than suspected after examination of this tumour that it was a cyst of the left ovary. Complete separation of the pedicle of a dermoid cyst is not unknown, and in such cases it is generally to the omentum that the cyst adheres. I have described and figured elsewhere1 a case under the care of Mr. Thornton 1 ‘ Clinical and Pathological Observations on Tumours of the Ovary, Fal- lopian Tube and Broad Ligament.’ Figs. 27, 28.