Pulmonary resection for metastatic malignancy. Three cases secondary to hypernephroma
✍ Scribed by Douglas Robb
- Publisher
- John Wiley and Sons
- Year
- 1948
- Tongue
- English
- Weight
- 351 KB
- Volume
- 36
- Category
- Article
- ISSN
- 0007-1323
No coin nor oath required. For personal study only.
✦ Synopsis
T h e diagnosis of massive spontaneous intraperitoneal hzmorrhage is usually made at laparotomy or autopsy. When confronted with this condition in the male, paracentesis will differentiate it from severe internal homorrhage in the gastro-intestinal tract. If operation is performed, a lower abdominal incision will be the best i n the female, as the commonest cause of intraperitoneal haemorrhage is ectopic pregnancy, other lesions of the ovary, and ruptured uterine veins.
In the male, an upper midline incision should be used, as this allows adequate exposure of the liver and spleen and their vessels. When these organs are not the cause, the mesenteric and gastric vessels are carefully examined for the bleeding point, ligature of which is a life-saving measure. Finally, the diaphragm is examined for bleeding from a ruptured varicose vein.
SUMMARY
I. Twenty-eight cases of massive spontaneous hamoperitoneum have been tabulated.
The history and progress of a further case which recovered after laparotomy is given.
The aetiology is discussed.