Gynaecology for students and practitioners . an ovarian facies in such cases—a peculiar sallow tint of the skin, withan expression of weariness and suffering. Owing to the popularizationof the operation for removal of ovarian tumours, cases are now veryrarely allowed to reach this advanced stage before surgical relief isobtained. Physical Signs. When pelvic in position a smaU ovarian cyst isinaccessible from the abdomen, but is recognized on bimanual examina-tion as an oval or globular, tense, elastic swelling lying as a rule behindthe uterus, which it displaces forwards. When uncomplicated, i
Gynaecology for students and practitioners . an ovarian facies in such cases—a peculiar sallow tint of the skin, withan expression of weariness and suffering. Owing to the popularizationof the operation for removal of ovarian tumours, cases are now veryrarely allowed to reach this advanced stage before surgical relief isobtained. Physical Signs. When pelvic in position a smaU ovarian cyst isinaccessible from the abdomen, but is recognized on bimanual examina-tion as an oval or globular, tense, elastic swelling lying as a rule behindthe uterus, which it displaces forwards. When uncomplicated, it ismovable and not sensitive to touch. Its position is rarely exactlymedian, but it does not necessarily lie upon the side from which it CLINICAL FEATURES OF OVARIAN TUMOURS 709 grows. The pedicle may be palpated bimanually when the localconditions are favourable ; this is made easier by anaesthesia, or bypulling down the cervix with a volsella to put the pedicle on thestretch. Non-adherent cysts are movable independently of the uterus ;. Fig. 406. Large Ovarian Cyst in a Coloured Woman aged 47 (Hammond).The tumour contained 16| gallons of fluid. Dilated subcutaneous veins are seencoursing over the abdomen. There is only slight oedema of the lower extremities. adherent cysts are not, and care is then required in distinguishing themfrom uterine fibroids. The posterior surface of the cyst can be feltbest from the rectum. Usually cysts of this size are regular in contourand uniform in consistence. Rounded tense projections due to thepresence of daughter-cysts on the surface may, however, be found ;sometimes a densely hard area may be felt at some part of the surface, 710 GYNECOLOGY suggesting that the tumour is a teratomatous cyst containing a bonyor cartilaginous plate in its wall. Small ovarian cysts are occasionally found in the utero-vesicalpouch instead of in the pouch of Douglas, in which case the uterusbecomes partially or entirely retroverted. It is a curious and intere
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
