. The diagnosis and treatment of diseases of women. d tumor andmoderate ascites. The obesity was very apparent on inspection. On palpating, to 162 GYNECOLOGIC DIAGNOSIS determine if there were any further causes for the prominent abdomen, I foundthat there was a distinct mass extending upward from the pelvis into the centralabdomen. Nothing more was found on palpation, except considerable tendernessover the tumor. Passing to percussion of the abdomen, with the patient lying onher back there was dullness over the mass extending, in the median line, to a shortdistance above the umbilicus and ext
. The diagnosis and treatment of diseases of women. d tumor andmoderate ascites. The obesity was very apparent on inspection. On palpating, to 162 GYNECOLOGIC DIAGNOSIS determine if there were any further causes for the prominent abdomen, I foundthat there was a distinct mass extending upward from the pelvis into the centralabdomen. Nothing more was found on palpation, except considerable tendernessover the tumor. Passing to percussion of the abdomen, with the patient lying onher back there was dullness over the mass extending, in the median line, to a shortdistance above the umbilicus and extending symmetrically to each side. In tryingto determine accurately the area of dullness in the left side, I found that it extendedhorizontally along the flank as shown in Fig. 194. Percussion in the right flankshowed about the same area of dullness there. The patient was then directed tostand and percussion was again employed. When standing, the area of dullness wasas shown in Fig. 195. A comparison of these two outlines (Fig. 196) makes it plain. Fig. 194. A case of Ascites and Tumor. Same patient as shown inFig. 118. Showing the Area of Dullness with patient on her Back. Thecentral dullness is caused by the tumor and the lateral dullness by asciticfluid. The dullness is practically the same on the two sides. that there was an unchanging area of dullness (due to the tumor) and a changingarea of dullness, due to free fluid in the peritoneal cavity (ascites). Encysted Fluid. This may be serum or ordinary pus or tubercular pus. Thereis dullness over the mass and resonance elsewhere (Figs. 197, 198). There is nochange in the outline of the dullness on change of position of the patient, such asoccurs with free fluid. A rather rare condition of special interest coming under this category is thepseudo-cyst of the lesser omental cavity. An encysted collection of fluid occupy-ing the cavity occasionally appears several weeks or months following an abdom-inal injury. Injuries so result
Size: 1738px × 1438px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, booksubje, booksubjectgynecology
