. Atlas and epitome of gynecology . assed intothe cervix, beside the tumor (corpus uteri), for quite adistance—further in front than behind (from 3 to 4 cm.).Bimanual palpation is of importance ; it demonstrates theabsence of the uterus from its usual position and the pres-ence of the peritoneal funnel. Treatment.—If due to a tumor, enucleation of thesame, whereupon the uterus usually reinverts itself spon-taneously. If irreducible from proliferative thickening ofthe uterine wall, amputation of the organ close to theexternal os, carefully closing the peritoneal funnel withsutures. In acute pue
. Atlas and epitome of gynecology . assed intothe cervix, beside the tumor (corpus uteri), for quite adistance—further in front than behind (from 3 to 4 cm.).Bimanual palpation is of importance ; it demonstrates theabsence of the uterus from its usual position and the pres-ence of the peritoneal funnel. Treatment.—If due to a tumor, enucleation of thesame, whereupon the uterus usually reinverts itself spon-taneously. If irreducible from proliferative thickening ofthe uterine wall, amputation of the organ close to theexternal os, carefully closing the peritoneal funnel withsutures. In acute puerperal inversion, manual reposition(as in phimosis), trying to push back the portion in con- 56 VAGINAL AND UTERINE INVERSION tact with the external os first, and making counterpressurefrom the abdomen to prevent elongation and possiblelaceration of the vagina. The earlier the attempt is made, the more likely is it tobe crowned with success. If manual reposition fails, theparts are to be carefully disinfected and pushed back by. Fig. 24.—Complete inversion of the uterus from a myoma of thefundus. (See Plate 3.) (Original diagrammatic drawing.) the colpeurvnter (always to be filled after introduction) orby means of astringent tampons. These are held in posi-tion until the tumor is partly reduced, when the reinver-sion is completed by cold-water injections. Massage ofthe uterus assists the action of the colpeurynter, and ergot VAGINAL AND UTERINE PROLAPSE. 57 effects the contraction of the organ. Elevations of tem-perature give warning of the onset of pelvic peritonitis,when all attempts at reduction must be discontinued. Celiotomy is indicated only in extreme cases. A bettermethod is that of KiAstner, who makes an incision in theposterior vaginal vault, which enables him to incise theposterior uterine wall throughout its entire length, and torein vert the organ. Kehrer attacks the uterus throughthe anterior vaginal vault. ?8. PROLAPSE OF THE VAGINA AND UTERUS. When the ext
Size: 1953px × 1280px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, bookidatlasepi, booksubjectwomen
