A textbook of obstetrics . found the womb PUERPERAL SEPSIS. 693 completely ruptured at the fundus from tube to tube. The diag-nosis of the injur\- had not been made. The operation wasundertaken some weeks after labor, for what was thought tobe an intraperitoneal abscess. .Areas of suppuration were dis-covered, but the greater bulk of the inflammatory mass wasexudate which had shut off the general peritoneal cavity frominfection through the gaping uterine wound. Indications for the Operation.—The indications for hysterec-tomy during puerperal sepsis are furnished by the condition ofthe pelvic o
A textbook of obstetrics . found the womb PUERPERAL SEPSIS. 693 completely ruptured at the fundus from tube to tube. The diag-nosis of the injur\- had not been made. The operation wasundertaken some weeks after labor, for what was thought tobe an intraperitoneal abscess. .Areas of suppuration were dis-covered, but the greater bulk of the inflammatory mass wasexudate which had shut off the general peritoneal cavity frominfection through the gaping uterine wound. Indications for the Operation.—The indications for hysterec-tomy during puerperal sepsis are furnished by the condition ofthe pelvic organs when they are exposed to sight and touch afterthe abdomen is opened. The four cases described above are thetypes calling for hysterectomy. It is not often possible to deter-mine upon hysterectomy before the abdomen is opened, but itshould be remembered that in any abdominal section for puer-peral sepsis hysterectomy may be necessary. The careful ob-stetric surgeon, therefore, should be provided with the implements. 1 &• 493-—Suppurative ovaritis (rear view). required for amputation of the womb in even- abdominal sectionfor puerperal sepsis, and should be prepared to remove the wombfor any one of the four indications described above, but shouldrest content with the least radical measure that promises hispatient safety. The operation that is quickest done and shocksthe patient least is most successful, provided, of course, that it isa dec mate. Technic of the Operation.—There are two points in which thetechnic of hysterectomy for puerperal sepsis may differ from thetechnic of the operation performed for other conditions. Oneof these points is the necessity often of doing pan-hysterectomy ;the other is the necessity often of tying the ligatures in a broadligament much thickened by inflammatory exudate or by ligatingthe blood-vessels separately so as not to include an infected massin the ligature. The authors preference is strongly for amputation of theuterus, leaving
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Keywords: ., bookcentury1800, bookdecade1890, bookidtex, booksubjectobstetrics
