Extrophy of the bladder / by C.B. King.

  • King, C.B.
Date:
1875
Catalogue details

Licence: Public Domain Mark

Credit: Extrophy of the bladder / by C.B. King. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    EXTROPHY OF THE BLADDER. By 0. B. KING, M.D., OF PENNSYLVANIA. Wm. J. Kilpatrick, aged 13, was admitted to the Western Pennsylvania Hospital, at Pittsburgh, April 10,1874, for congenital deficiency of anterior wall of abdomen and bladder. The posterior wall of the bladder projects forward, and forms a tumor about the size of a goose’s egg, oval in shape, measuring 2f inches across from side to side, and 2^ inches from above down- wards. In the erect position the tumor protrudes 1^ inches, and measures around the oval from side to side 4^ inches. No hernia. Pubes wanting 2f inches. Penis epispadic, about the size of an almond, and covered with an imperfect prepuce. Scrotum quite small, and contains two well-developed testicles. For some time previous to the operation, the patient was put upon tonics and nourishing diet with gentle out-door exercise. May 3. He took an ounce of castor oil which operated freely. The following morning the lower bowel was washed out by enema, and the patient being put under the influence of ether, a horseshoe- shaped incision was made; beginning about one and a half inches to the left, and a little above the penis. This incision was carried down close to the left thigh, then across the perineum to the oppo- site thigh just in front of the anus, and then upward to a corre- sponding point on the right side. The flap was dissected up, laying bare the testicles. An oval incision was made in the flap to allow the penis to drop through. Another incision, beginning about three-quarters of an inch above the starting-point of the first incision, was made through the skin of the abdomen and extend- ing around and about one-half inch above the upper edge of the bladder to a corresponding point on the opposite side. The skin was dissected up about three-quarters of an inch. The first flap was then turned up over the bladder, and its edges placed beneath e last flap, and held in position by eight silver wire sutures secured by perforated shot.