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Complications. — In one case the adhesions were so very
extensive that dangerous haemorrhage ensued a few hours
after the operation. The wound was partially reopened,
without ansesthesia, and a very large tampon (several yards)
of iodoform gauze Order Bactrim Online introduced. This controlled the hsemor-
rhage, but a few days later a faecal fistula appeared at the
wound and remained open three weeks, finally closing spon-
taneously.
In one case, in cutting tl>rough the parietal peritonaeum,
the intestine, which was slightly adherent beneath the line
of incision, was wounded for a distance of an inch and a
half. The opening was quickly closed with silk sutures.
The patient Bactrim 500 Mg made a good recovery. In another case, where
the adhesions had become numerous and well organized
(a case of tubercular peritonitis and salpingitis), the au-
topsy showed a small perforation of the bladder, with escape
of urine.
In a fourth case, one of acute intestinal obstruction, no
cause for obstruction could be found at the operation, but
a Bactrim 480 Mg very careful examination at the autopsy revealed a fract-
ure of the spine in the lower dorsal region with no dis-
placement. This had evidently caused intestinal paralysis,
but had caused no other symptoms.
All the operations were performed in the amphitheatre,
and after the operation the patients, with a few exceptions,
were taken Bactrim Alternatives to the general wards.
NEOPLASMS.
Cystic Tumors of the Ovary Bactrim 10 Mg ; Complicated Cases. — rThe
maiti points of importance in the cases belonging to this
class will be found summarized in the accompanying table.
A few of the cases deserve special mention. Of these, the
first was a case of colloid cysts of the ovaries with salpin-
gitis.
Cask I. — Tlio pntieiit Wiis a women twenty-eiglit years old.
married, but had never l)orne children; she had had several
miscarriages. lier general lieiilth was good uj) to within a
year previous to adinission, wlien she had an altaok of pelvic
peritonitis ; since then she had had two or three recurrent at-
tacks with an increase in severity. She was admitted in Xo-
vember, 1889. Nothing could be felt in the abdomen externally,
but, by vaginal examination, a mass of about the size of an
orange could be felt on either side of the uterus. The uterus
itself was moderately fixed.
Operation, November 30. 1889. — The contents of the pelvis
were firmly matted together by old, organized adhesions.
On the right side, in tlie region of the ovary, was found a cyst
of about the size of an orange and filled with colloid material.
In the same region on the left side there was a somewhat larger
cyst, containing clear yellow serum. The ovaries could not be
recognized, but the tumors, along with the Falloppian tubes,
were removed. The haemorrhage from broken Bactrim 960 Mg adhesions was
considerable, but controlled by cautery and iodoform tampon,
which Bactrim Ds Mg was introduced alongside of the glass drainage-tube.
The operation was followed by severe shock, but the patient
made a good recovery. The glass tube was taken out at the
end of twenty-four hours, and the iodoform tampon two days
later. A sinus remained at the site of the tube, and has resisted
several subsequent attempts to close it. The pathologist's
report showed that ovarian structure was present in the masses
removed. Four weeks after the operation the patient began to
menstruate, and has continued to do so at regular intervals since.
Case II. MuUihrnlar Cyst of the Ovaries; Rapid Enlarge-
ment; Loss of Ilesh and Strength; Conditions simulating
Malignancy. — The patient was a woman fifty-three years of
age, married, and the mother of four children. She had been
well up to within a year previous Buy Generic Bactrim to entering the hospital, when
she first noticed pain in the right iliac region. Three months
ater a swelling ai)peared in the same locality, and increased
steadily in size. The loss of flesh and strength was rapid and
progressive. For the last six weeks there h.ad been symptoms
of pressure Bactrim Ds Price upon the bladder and rectum, together with a
bloody discharge from the uterus. For nearly a year menstrua-
tion had been slightly more frequent than usual, and more pro-
use, and recently had shown considerable odor.
At the time of admission the lower portion of the abdomen
was occupied by a spheroid tumor, smooth, fluctuating, slightly
more prominent on the right side, and extending three inches
above the umbilicus. By the vagina the cervix was felt low
down and abnormally hard. Douglas's cul-dc-sac was filled
with a hard, smooth mass, apparently solid.
Operation, March 1, 1890. — -The tumor proved to he a large
cyst filled with chocolate-colored fluid (20 litres). The cyst was
multilooular, and evidently had Bactrim Ds Cost originated from the right ovary-
On the left side, behind and below the uterus, was found a
second cyst, of the size of a child's head, so tense that it strongly
simulated a solid tumor. Unlike the former, it contained clear
yellow fluid (30 ounces). It was firmly adherent to the sigmoid
flexure, and considerable hreniorrhage resulted from separation
of the Bactrim Ds Generic adhesions. The glass tube was left in the abdomen for
six days; quite a large amount of fresh blood was withdrawn
from the tube the first three days, and the pulse ranged from
120 to 140. The wound healed primarily and the sinns (juickly
closed ; but at the end of two weeks she had a sharp attack
of local peritonitis. A small mass of oineutuin had been tied
off during the operation, and this was undoubtedly the cause
of the trouble. A hard, very tender mass, intraperitoneal, could
be felt three inches above the umbilicus. The |)atient made Bactrim 800 a
good recovery. In August (five months after the operation)

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