A textbook of obstetrics . thestructures attached to it, usually thebowel or omentum. A bacteriologicalexamination of some of these cases hasshown the presence in the uterine wallof pyogenic staphylococci. If the pelvic connective tissue is in-volved, it is at first edematous. Theliquid is then absorbed, leaving a denseinfiltrate, if there has been much cell-proliferation, or entirely disappearing if the cell-element is scant) infiltrate, if not too extensive, is likewise absorbed inabout four-fifths of all cases. Occasionally, however, in aboutone-fifth of the cases an abscess results, w
A textbook of obstetrics . thestructures attached to it, usually thebowel or omentum. A bacteriologicalexamination of some of these cases hasshown the presence in the uterine wallof pyogenic staphylococci. If the pelvic connective tissue is in-volved, it is at first edematous. Theliquid is then absorbed, leaving a denseinfiltrate, if there has been much cell-proliferation, or entirely disappearing if the cell-element is scant) infiltrate, if not too extensive, is likewise absorbed inabout four-fifths of all cases. Occasionally, however, in aboutone-fifth of the cases an abscess results, which may be openedabove Pouparts ligament, or through the vaginal vault withoutentering the peritoneal cavity, but which may rupture into theabdominal cavity, 01- may perforate the rectum, bladder, vagina,or uterus. In eases of cellulitis from diphtheric or erysipelatous inflam-mation the edema rapidly becomes seropurulent, in flu- formercase the inflammation rapidly becoming diffuse, in the latterp«issibly being Fig. 496. — Dissectingmetritis. Specimen expelled by I!. 1. 664 ((rar-rigues). (The figure is two-thirds natural size.) PUERPERAL SEPSIS. 699 Diagnosis.— The diagnosis of metritis is very difficult to make. The womb is large in size, the walls feel boggy, andthe uterus is very sensitive to pressure; but it is almost impos-sible to be positive that metritis exists unless one can feel anabscess in its walls by an intra-uterine examination, or unlessthe collection of pus breaks into the uterine cavity. If the abdomen must be opened for the septic infection, thecondition of the womb is, of course, easily determined. .Ab-scesses may be seen in its walls, and ulceration may so nearlyperforate them that when the operators finger is laid upon theperitoneal covering of the womb, it penetrates at
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Keywords: ., bookcentury1800, bookdecade1890, bookidtex, booksubjectobstetrics
