A System of Operative Surgery, Volume IV (of 4)

uterus fall in

ological

etric i

to the pre

ant uterus in the course

nds of the pr

ds of the pr

ith a sound, dilator, or forceps in the operation of curetting. Many cases are known in which the uterus

ion of the uterus has been followed by a rapidly fatal peritonitis;

o urge that if, in the course of dilatation and curettage of the uterus, a rupture or perforation of the uterine wall occurs, it

tomy should be performed. Sometimes a pelvic abscess occurs as a sequence to the accident, and will require evacuation through the vaginal fornix, or, perhaps, by means

are that such has happened, and proceeds to flush out the uterine cavity with poisonous antiseptic solutions, especially

tomy). A serious complication of tears or rents of the uterine wall, whether the uterus is gravid or non-gravid, is extrusion or prolapse of the intestine. It is also remarkable that in several rep

of the bowel with sutures, resected the mesentery belonging to the removed bowel, and thus saved the patient's life. In another case, where a practitioner had torn the uterus during curettage and intestine appeared i

aware of it, and withdrew eight inches of intestine, thinking it to be secundines; he recognized the error, and pushed the i

reatment. Much depends on the circumstances of the case, the character of the i

of Munich collected 141 instances of such injuries, and of these twenty-three died chiefly from septic peritonitis. Among these injuries seventy-

?tus is hindered or obstructed by narrowness of the pelvic outlet, tumours, or undue size of the child. This form of injury is called spontaneous r

ssued from lying-in institutions deal with extensive figures, but unfor

ds of dealing with ru

ely, which means at most lightly pa

my and stitching up t

dominal route, as this enables the pe

ans is this: in cases of complete rupture, in which the f?tus and membranes

n published by Walla, Klie

ed upon, with a mortality of 44 per cent.; 198 were not operated upon, 96 recovered and 102 died-a mortality of 52 per cent. Among the unoperated cases some were no

te operation. Lacerations of the vagina make the progn

treatment of complete rupture of the gravid uterus will be more frequently undertaken in the future than it has in th

the detached intestine cut away, and the proximal end of the bowel anastomosed into the c?cum. A long rent in the posterior wall of the uterus was closed with sutures. The patient survived the accident ten da

ally when the abortion is self-induced. Kehr has recorded an example of a desperate effort of this kind:-A widow, twenty-nine years of age, when in the fifth month of an illicit pregnancy, fired a

goat, falls upon the belly, or a fall downstairs, or the woman may be run over. The treatment to be adopted in these conditions varies widely with the circumstances. As a general rule it may be stated that the most

the horn of a bull. An interesting collection of cases illustrating this accident has been made by Robert P. Harris. Even after very seve

erus in which the pregnancy has advanced as far as the sixth month has been removed under the impression that it was a large ovarian cyst, and this accident has happened with a pregnant uterus greatly enlarged in the somewhat rare condition known as hydramnios. A pregnant u

course of an abdominal operation three courses are open to him, ea

e incision i

m C?sarea

terus (subtotal

rus during ovariotomy has terminated fatally, especially when th

at the best results follow for the patient when the surgeo

t what was supposed to be a cyst of the right ovary. When tapped it was found to be a gravid uterus, in which p

ely to happen now, for the clumsy ov

egnancy. The bullet was extracted from under the skin on the left side, four inches behind the anterior superior sp

licated with injury of the intestines; it is for this reason that the canon of surgery applicable to penetrat

escapes. In operating, the anterior as well as the posterior surface of the uterus should be carefully examined in order to determine if the bullet passed through this organ. In some instances

indicates that the best results follow c?liotomy, with suture of the perforated intestine and the hole or holes in

d consequences follow the conservative oper

f the small intestines, and the mesenteric artery was wounded. He resected 20 centimetres of small intestine. A loop of umbilical cord protruded throug

ll intestine: he sutured the wounds in the uterus and the holes in the

. The patient, who was in the eighth month of pregnancy, quickly miscarried. The bullet was found in the déb

etails of a case in which a pregnant woman was stabbed in the buttock. The knife passed through the great sciatic notch, and penetrated the uterus and

und healed. Six weeks after the injury the woman was delivered of a live male child, normally developed, but much of the child's large and small intestines protruded through an openi

ere

térus gravide par balle de revolver. Bull. et Mém.

gravide par balle de revolver. Bull. et Mém.

terus. The Clinical Journal, 1908, xxxi. 289. On two cases of Abdominal S

Uterusperforation. Zentralb

Trauma of the Uterus. The Am. Jour

causing the removal of 126 inches of Small Intestine

Rupture of the Non-parturient Uterus

échancrure sciatique jusqu'à l'utérus gravide et jus

he Abdomen and Uterus of Pregnant Women. T

du traitement des ruptures de l'utérus pendant

instrumentalen Behandlungen. Zentral

-parturient Uterus, with report of cases. T

sverletzung des graviden Uterus. C

of the Uterus. Brit. Med

rative Behandlung der Uterusruptu

-wound of the Pregnant Uterus. B

tero from Gunshot-wound: Recovery o

?tus in utero. Surgery, Gyn?colo

Australian Med. G

abdominale Totalextirpation. Heilung.