File:Treatise on gynaecology - medical and surgical (1894) (14593777120).jpg

Identifier: treatiseongynaec02pozz (find matches)
Title: Treatise on gynaecology : medical and surgical
Year: 1894 (1890s)
Authors: Pozzi, Samuel, 1846-1918 Wells, B. H., tr
Subjects: Gynecology Generative organs, Female Women Gynecology Genital Diseases, Female Gynecologic Surgical Procedures
Publisher: New York : William Wood & Co.
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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oextensive adhesions, we probably have to do with a hydro-salpinx;j)ressure is less joainful than in the case of a purulent cyst. While the tumor is still movable, we may mistake it for a smallovarian cyst, and especially for an intra-ligamentous cyst. The latter,however, is more decidedly lateral, and is not usually separated fromthe uterus by the space corresponding to the XDedicle of the tubal cyst.The differential diagnosis from tubal pregnancy in the first fourmonths is almost impossible to make with certainty. In the majorityof cases where these foetal cysts have been extirpated, the operationhad been undertaken for a supposed salpingitis. Hypertrophy of theuterus and expulsion of a decidual membrane are the only diagnosticsymptoms. Menstruation may continue to be normal. An inexperienced examiner is very apt to mistake large serous orbloody cysts for uterine fibromata, and it is indeed often very diffi-cult at first to distinguish the one from the other. But the uterine h- I a.
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o z i ^ o X ^ (0 Q, r t- o CQ cn in u u (0 \D z in 0 < (/) z u < I QC Q < _l 0 < cn Q ct Z Ul X z z 3 E -1 - Q. r\i o k CYSTIC OOPHOEO-SALPINGITIS. 43 sound, carefully used, will sliow a great increase in the uterine cavitywhen there is a fibroid, and a normal cavity in the case of tlie tubalaffection. Moreover, we may always jDcrceive fluctuation in hydro-and hgemato-salpinx if they be of any size, or if the patient be ana3s-thetized; it is surprising how different the sensation imi^arted is fromthat felt before the anaesthetic was administered. Pyo-salpinx withadhesions projecting into the cul-de-sac of Douglas often give thesensation of a pasteboard vagina. Is it permissible to make an exploratory puncture for the sake ofclearing up a diagnosis? It seems to me a dangerous procedure, how-ever far the tumor may be from the point of puncture; whether it beabdominal or vaginal. There is danger of wounding the intestines;especial danger of a

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