The abdomen looked like that of the sixth month of
pregnancy. The abdominal wall was tense, smooth, and without
lineae albicantes. Palpation revealed a cystic immobile tumor,
extending 2 inches above the umbilicus and apparently fixed by
deep adhesions. The fetal parts could only be made out with
difficulty by deep palpation, but the heart-sounds were easily
heard to the right of and below the umbilicus. By the right side
of this tumor one could feel a small one, the size of a Tangerine
orange, which hardened and softened under examination. When
contracted the groove between it and the large tumor became
evident. Vaginal examination showed that the cervix, which was
slightly deflected forward and to the right and softened, as in
uterine gestation, was continuous with the smaller tumor.
Cephalic ballottement was obtained in the large tumor. No sound
was passed into the uterus for fear of setting up reflex action;
the diagnosis of extrauterine gestation at about six and a half
months with a living child was established without requiring to
be clinched by proving the uterus empty. The patient was kept
absolutely at rest in bed and the edema of the left leg cured by
position. On April 30th the fundus of the tumor was 35 cm.
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