NOTES OF TWO CASES OF ACUTE PANCREATITIS
SURGEON TO THE VICTORIA ZENANA HOSPITAL, HYDERABAD, DECCAN, INDIA. THE fact that tumours of the nature of the one described in the following case occur but very rarely will perhaps be deemed an adequate reason for recording the case in THE LANCET. The patient was a healthy-looking young Mahomedan woman of fair complexion and of about 24 years of age. She was admitted to the Victoria Zenana Hospital on May 19th, 1910, complaining of a watery and very offensive vaginal discharge. She stated that
... e. She stated that she was then in the beginning of the fifth month of her fourth pregnancy; all former pregnancies and labours had been normal, and her three children were living. She had first noticed the discharge a month previously to admission, and it had gradually become more profuse and very offensive. No pain was felt, and the foetal movements were normal. The uterus corresponded in size to the period of pregnancy, and all the usual signs and symptoms were present. On vaginal examination a growth was felt springing from the base of the cervix, villous and friable, little pieces breaking away on the finger. When seen by means of Auvard's speculum, the cervix being drawn down by a vulsellum, the I tumour presented the appearance of a cauliflower, was fleshy pink in colour, and consisted of three separate portions, each springing by a pedicle from the mucous membrane, where it was reflected from the vagina over the cervix. The growth encircled the right half of the cervix, the centre portion having the broadest pedicle. The patient was ansesthetised with chloroform, and after ligaturing the pedicle in the hope of thereby preserving the specimen the tumour was removed with scissors. The deeper tissues were not involved, and the mucous membrane was stitched to stop oozing, which was free. The growth was at once placed in rectified spirit and has been sent to the Museum of the Royal College of Surgeons of England. The patient was discharged from hospital at her own request on June 2nd. There were no symptoms after the operation ; the discharge quite ceased on removal of the tumour. Although asked to return to the hospital for her confinement the patient did not do so and was not seen again. The growth exactly tallied with the description given of true cauliflower excrescence in Herman's " Diseases of Women," except that it did not grow from the margin of the os, nor was it quite so firm in consistency as a cauliflower. The latter characteristic might be due to the general softening and increased vascularity of pregnancy. Hyderabad. NOTES OF TWO CASES OF ACUTE PANCREATITIS.