Case of extra-uterine fœtation treated by abdominal section : recovery / by J. Braxton Hicks.

  • Hicks, J. Braxton (John Braxton), 1823 or 1825-1897.
Date:
1868
Catalogue details

Licence: Public Domain Mark

Credit: Case of extra-uterine fœtation treated by abdominal section : recovery / by J. Braxton Hicks. Source: Wellcome Collection.

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    rather improved, hut was still very ill. There was great distension of the abdomen with extreme tenderness, making examination difficult. Some of the enlargement was due to tympanitis, but in the left hypogastrium there was dulness with distinct fluctuation. On the right side also there was dulness reaching to rather the level of the umbilicus, extending over a space of about six inches diameter, reaching downwards towards the pelvis, and apparently continuous with the swelling on left hypogastrium. Upon pressure the fingers appeared to impinge on a solid firm body, after passing through fluid, but the pain it gave made examination difficult. Examination per vaginum showed a considerable bulging on the left side of the passage, the os uteri being displaced high up to the right side. The swelling on the left was not so firm as the uterus, but somewhat yielding on pressure. Taking into account the history, with the fact that all had come on within five months and a half (in which period it would be exceedingly rare that any growth otherwise than one connected with conception could rise so high in the abdomen), I considered that it was most probably a case of extra-uterine fetation. I saw her again about a week after during which interval she had materially become worse; more irritative fever; tongue tending to aphthae, and pulse from 120 to 130. She mentioned that she had had a few days before very severe pain in the tumour of the right side, which had been relieved by a rather free diarrhoea. This tumour, instead of being dull, was now resonant on per¬ cussion ; and the finger impinged readily through gas on to the solid beneath. The stratum of gas seemed about half an inch thick. Thus it appeared highly probable that communi¬ cation had been set up with the intestine, and that putrid decomposition had arisen. I may here remark that she had the peculiar sweet so-called hepatic breath—a state I have always found co-existing with collections of putrid matter within the system. A week after this Dr. Oldham saw the case with me, and arrived at the same conclusion as to its nature which I had entertained. There was at this examina-