Gynecological diagnosis and pathology . pinx). It is difficult to recognise the ovary () clinically ; and even in a naked-eye specimen a dilated tube maysimulate a Broad Ligament cyst (see fig. 171). Careful examination shows 180 GYNECOLOGICAL PATHOLOGY that the fimbriated end of the tube is not seen, being adherent to theovary. A large Parovarian cyst filling the abdomen differs from an Ovariancyst in the following features. It is of slow growth, has thin walls, andbeing mono-cystic gives fluctuation with great distinctness. It suggestsin the first instance ascites, but more careful ex
Gynecological diagnosis and pathology . pinx). It is difficult to recognise the ovary () clinically ; and even in a naked-eye specimen a dilated tube maysimulate a Broad Ligament cyst (see fig. 171). Careful examination shows 180 GYNECOLOGICAL PATHOLOGY that the fimbriated end of the tube is not seen, being adherent to theovary. A large Parovarian cyst filling the abdomen differs from an Ovariancyst in the following features. It is of slow growth, has thin walls, andbeing mono-cystic gives fluctuation with great distinctness. It suggestsin the first instance ascites, but more careful examination shows that thefluid is encysted. On opening the abdomen, the tumour is seen to becovered by peritoneum; and after removal the ovary and tube will befound separate from it, or thinned out and stretched in the wall. The slow development of a Parovarian cyst, its temporary cure bytapping, and the large size it may attain are well illustrated by thefollowing case :— J. D., age 33, has noticed swelling of abdomen for six months,. Fig. 172.—Parovarian Cyst with Twisted fimbriated end of the tube is greatly congested. with some pain for three months in left iliac region. Five years ago aswelling, similar to the present, was noticed; and after twelve months,was tapped, and eight pints of clear fluid drawn off. Menstruationregular. Abdomen distended to size of an eight months pregnancy,with a globular swelling. Surface uniform. Fluctuation very markedall over it. Dulness over abdomen, except iu lumbar, epigastric, andhypochondriac regions. Auscultation negative. On vaginal examination,the fluctuating tumour is felt, with the uterus separate from it andretroverted. Abdominal section showed a thin-walled cyst, covered byperitoneum, with dilated veins. Ten pints of clear light yellow fluiddrawn off. Pedicle secured by double ligature, and cyst unilocular; ovary and tube seen stretched on wall of cyst, fromwhich also peritoneum could be easily stripped
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
