. The diagnosis and treatment of diseases of women. Fig. 159. The Central Lower Abdomen, showing tiie organs conmonly affected by local disease. Pelvic Inflammation. Pelvic inflammation in any form is likely to give rise totenderness extending throughout the lower abdomen. Even if the inflammationis confined strictly to the tube on one side, there is usually some tendernesson pressure in the median line. There is a history of pelvic inflammation,with characteristic tenderness of the affected adnexa in the bimanual examination,and perhaps also a distinct mass. 142 GYNECOLOGIC DIAGNOSIS Bladder
. The diagnosis and treatment of diseases of women. Fig. 159. The Central Lower Abdomen, showing tiie organs conmonly affected by local disease. Pelvic Inflammation. Pelvic inflammation in any form is likely to give rise totenderness extending throughout the lower abdomen. Even if the inflammationis confined strictly to the tube on one side, there is usually some tendernesson pressure in the median line. There is a history of pelvic inflammation,with characteristic tenderness of the affected adnexa in the bimanual examination,and perhaps also a distinct mass. 142 GYNECOLOGIC DIAGNOSIS Bladder Disease. The tenderness is very low, just above the pubes (Fig. 161).There is a history of frequent, painful urination. Pressure on the affectedregion may cause a desire to urinate. Examination of the urine will show evidencesof bladder or kidney disease. Tubercular Peritonitis. This tenderness is widespread over the is encysted fluid or a mass of exudate or general ascites. The trouble isusually chronic. There may be evidence of tub
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