. Operative gynecology. The growth of thetumor in most cases was slow; one womanhad noticed hers for ten years before opera-tion, and others for six or seven years, whileanother had only known of its presence forthree months. Observations as to the slowdevelopment can of course only be appliedto cases in which the tumor had already at-tained a size suificient to produce distentionand be felt through the lower abdominalwall. Where the tumor lying in the pelviswas small the patients were unconscious ofthe existence of any of seventeen eases the tumors were found eight times on the left
. Operative gynecology. The growth of thetumor in most cases was slow; one womanhad noticed hers for ten years before opera-tion, and others for six or seven years, whileanother had only known of its presence forthree months. Observations as to the slowdevelopment can of course only be appliedto cases in which the tumor had already at-tained a size suificient to produce distentionand be felt through the lower abdominalwall. Where the tumor lying in the pelviswas small the patients were unconscious ofthe existence of any of seventeen eases the tumors were found eight times on the left sideand eight times on the right, and once occupying both left and right sides. The pedicle varies as in ovarian multilociilar tumors. Eight cases weredistinctly pediculated, seven had no pedicle at all, and one had a long twistedpedicle turned one and a half time upon itself. There can be no doubt that dermoid cysts are peculiarly prone to induceattacks of localized peritonitis. This tendency is difiicult to explain,. Fig. 422.—Left Dermoid Cyst of theOvary with a Long Pedicle. The cyst (D) lay in the median lineand could easily be pulled high up in theabdomen or displaced into either flank inthe position of tlie dotted lines. No. 2554. DERMOID CYSTS OF THE OVARY. 2Y9 and seems inherent even in the smallest cysts, which are often found matted ina dense mass of adhesions; on the contrary, however, I have seen a cyst as largeas a mans head entirely free from adhesions. I found eight out of nineteencases not at all adherent, while the other eleven were more or less fixed byadhesions varying from the slight velamentous attachment to the densest fibrousunion. Owing to this liability to provoke attacks of peritonitis involving the im-mediately surrounding structures, inflammatory disease involving the other ovaryand tube is frequently found. This generally consists in adhesions bindingdown the tube and ovary, often associated with hydrosalpinx (see Fig. 423).
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectgenitaldiseasesfemal
