Medical and surgical report (1909) (14787787573)

Tumor emboli from uterine curettage in sarcoma
Identifier: medicalsurgicalr02city (find matches)
Title: Medical and surgical report
Year: 1909 (1900s)
Authors: City Hospital (Blackwell's Island, New York, N.Y.) New York (N.Y.). Dept. of Public Welfare
Subjects: Medicine
Publisher: New York : City of New York Dept. of Public Charities
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons



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ther profuse flow of bright red blood. No further abnormali-ties were discovered in the pelvis. Treatment.—The patient was treated by the usual palliative measures,but as the flow persisted with only a slight diminution, on June 18th she wasgiven a general anesthetic. Examination under the anesthetic revealed noth-ing more than had already been learned. The cervix was very soft anddilated very readily. On introducing the curette into the uterus, a veryprofuse bleeding occurred and persisted until the uterus was tightly packed.The interior of the uterus seemed very soft, but very little tissue was re-moved by the curettage. Recovery was uneventful. The packing was re-moved gradually, and all was out on the fifth day. The bleeding hadentirely ceased. Pathological Findings.—The curettings contained many spindle and poly-hedral-like cells, with numerous myotic figures. Very little normal endo-metrial tissue was found. A diagnosis of mixed-cell sarcoma was renderedby the pathologist. J
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(Mtwmor embai*. (A.A.A.A). Tumor emboli. 176 CITY HOSPITAL MEDICAL AND SURGICAL REPORT This condition was carefully explained to the patient, and after somedelay she requested me to perform a second operation; so on June 30th,under ether anesthesia I made a transverse abdominal incision, four incheslong and two inches above the symphysis. This incision was carried throughthe anterior sheath of the recti, the sheath was freed from its attachmentsto the recti and linea alba above and below the incision for about twoinches. The recti were then separated and a longitudinal incision madethrough the peritoneum. With the patient in a high Trendelenburgs posi-tion, this incision gave me a very good exposure of the pelvic contents. Inow made a careful inspection of the uterus and adnexa, but discoverednothing abnormal save for a moderate enlargement of the uterus. Onpalpation I could feel no tumor masses nor any enlargement of the retro-peritoneal lymphatics. However, in view of the pathologic