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Ectopic Pregnancy Dr John F Erdmann

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ECTOPIC PREGNANCY.

DR. JOHN F. ERDMANN reported a case of ruptured tubal pregnancy and showed the fresh specimen. The patient was twenty years old, who, after skipping one menstrual period, was seized with an attack of pain in the lower abdomen, followed by syncope and subsequently by well-marked symptoms of peri tonitis.

Upon opening the abdomen, Dr. Erdmann found the ab dominal cavity filled with a large quantity of clotted blood. The hzmorrhage was traced to a rupture of the tube resulting from a tubal pregnancy. The rupture, which was in the tube only, was situated about an inch and one-half from the distal extremity of the tube. In the specimen shown, the fcetal sac was still intact, and was practically about one-third from the fimbriated ex tremity of the tube. The villosities covering the embryonal mem brane were adherent to the visceral and pelvic parietal evidently a case of positive tubo-abdominal abortion. ANEURISM OF THE AORTA ABDOMINAL'S.

DR. Orro G. T. KILIANI presented an autopsy specimen with the following history : A man fifty years old, was admitted to the medical side of the hospital last September. Up to the onset of his present illness he had always enjoyed good health; syphilis denied. Upon his admission, he complained of sharp pains in the epigastric region after eating. He had lost about twenty-five pounds in the last few weeks. He was kept under observation for a week, and then dismissed without any satisfactory diagnosis being made. About a week ago he was re-admitted, and in narcosis a tumor was felt in the epigastric region, partly under the left border of the ribs, corresponding to the position of the stomach. Test meal was not conclusive to cancer. Upon opening the abdominal cavity, the stomach presented itself perfectly nor mal, with the exception that it showed, near the middle of the small curvature, a small tumor of about the size of a large pea, which was considered as metastatic carcinoma. Behind and a little above the stomach there was found a tumor of the size of a fist. which gave the impression of a malignant tumor of the pancreas. Examining the tumor for the possibilities of extirpation, a dis tinct expansive pulsation could be felt. Nevertheless, the diag nosis of aneurism was not made, the pulsation felt being mis taken for a conducted pulsation. The supposed tumor of the pancreas being tightly adherent to the aorta by former peritonitic processes, including liver, spleen, kidney, and pancreas, an extir pation was deemed impossible, and the wound closed. The pa tient died on the third day of cedema of the lungs, and showed in the autopsy a luetic aneurism of the aorta, covered by the tightly adherent pancreas. The small tumor of the stomach mentioned above, which helped to induce me to address the affec tion as carcinoma, proved to be a fibromyoma of the wall.

tumor, pancreas, tube and stomach