. American journal of obstetrics and gynecology. 0 mm. mercury pressure the CO2 gas bubbled out ofthe sinus and when patient sat up the classic sign of shoulder pain was noted andgas seen under the diaphragm by the fluoroscope. This proved that the sinusconnected with the uterine cavity and made it seem certain that the other tubewas patent. 106 THE AMERICAN JOURNAL OP OBSTETRICS AND GYNECOLOGY On July lo, 1921, a supravaginal hystorectonu, bilateral salpingoooilioreetomy,excision of salpingoabdominal sinus and appendectomy done. By long elliptical in-cisions the whole scar and sinus were exci
. American journal of obstetrics and gynecology. 0 mm. mercury pressure the CO2 gas bubbled out ofthe sinus and when patient sat up the classic sign of shoulder pain was noted andgas seen under the diaphragm by the fluoroscope. This proved that the sinusconnected with the uterine cavity and made it seem certain that the other tubewas patent. 106 THE AMERICAN JOURNAL OP OBSTETRICS AND GYNECOLOGY On July lo, 1921, a supravaginal hystorectonu, bilateral salpingoooilioreetomy,excision of salpingoabdominal sinus and appendectomy done. By long elliptical in-cisions the whole scar and sinus were excised in one mass. On entering the abdomenit was seen that the sinus was the left fallopian tulie with its fimbriated end em-bedded in the scar. The tube was slightly enlarged and the lumen a bit dilatedbut there were no adhesions about it. The left o%ary a little enlar;,ed, buried underadhesions to the uterus, and on dissection sterile pus exuded. The right ovary wastransformed into a cyst of about four inches diameter. The riuht tube ran across. the top of the cyst, appeared normal, and the Rubin test had already proved itspatency. Light omental and intestinal adhesions to the back of the cyst and theuterus (Fig. 2). Uterus, appendix, kidneys and gall bladder normal. It appearedunwise to consider conservatism and accordingly complete ablation of uterus andadncxac was done. Prophylactic appendectomy also done. Because of the spill ofpus from the ovary a cigarette drain was inserted and the abdomen closed. Patient had a normal convalescence, the highest temperature being 101° on the twentieth day, drainage tract closed, wound healed, pelvis normalto palpation. Microscopical examination of the offending tube showed tliiikcned librosed wall NEW YORK OBSTETRICAL SOCIETY 107 with marked edema and congestion. Tlie blood vessels engorged, their walls thick-ened and sclerosed. Some areas of mucous membrane are infiltrated almost ex-clusively with round cells, others s
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