File:Treatise on gynaecology - medical and surgical (1894) (14777451231).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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a distance from their point of origin. These might appropriately becalled retro-peritoneal cysts. Any kind of cyst may travel in this fashion; it has es)3eciallybeen noticed in hyaline or papillary parovarian cysts, but also indermoid cysts and glandular ovarian cysts. On the left side, thetumor may stretch the iliac meso-colon and come in contact with theilium. I enucleated a hyaline parovarian cyst which had followedthis course. On the right side, the cyst may go as far as the caecum,or even pass beyond it within the mesentery, to the kidney,^^ liver, VOL. II.—8 114 CLINICAL AND OPERATIVE GYNECOLOGY. and diapliragm.^ Posteriorly, the cul-de-sac of Douglas may be liftedup, and the cysts lodge between the rectum and uterus.^ Anteriorly, the vesico-uterine cul-de-sac is sometimes displacedupward; the bladder, pulled upon by it and the urachus, is enor-mously elongated, and liable to be wounded by the knife of the oper-ator. Laterally, the cystic masses glide under the peritoneum, be-
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FiG. 41.—Retro-peritoneal Dermoid Cysts (Sanger). The tumor, which is the size of a foetal head,occupies the superior pelvi-rectal space behind and to the right of the rectum. K, Cyst; U, uterus ; R,rectum : V, vagina ; P, peritoneum ; Ead, right levator ani; Eag, left levator ani; Jr, ischio-rectal fossa ;Ur, urethra. tween it and the iDelvic aponeurosis or even into the iliac fossa, pressupon the ureter, and are often the cause of renal disease. The papil-lary and glandular cysts of an areolar or gelatinous variety are theones which give rise to the most extended and most serious cases ofretrcj-peritoneal migration; contrary to the hyaline parovarian cyst,they form adhesions to neighboring parts and are difficult and often PATHOLOGICAL ANATOMY OF OVAEIAN CYSTS, 115 impossible to enucleate. Dermoid cysts have been found in the retro-peritoneal pelvic cellular tissue. The mistake has often been made of supposing that they originatedfrom the walls of the bladder, rectum, or uterus to

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