. Pelvic inflammation in women. on the exudative process islimited to a serous and poorly defined cellular infiltration, for the bac-teria quickly pass through the lymphatics to the peritoneum or into theblood stream. Fortunately for the protection of the individual, in mostcases there is an adequate protective tissue reaction zcith the formation oflarge exudates. Section through these masses shows the lymph vessels 88 PELVIC INFLAMMATION IN WOMEN thickenedT tortuous and beaded, and a yellowish or whitish pus exudesfrom numberless minute openings. The lymphatic chains are surroundedwith exudat
. Pelvic inflammation in women. on the exudative process islimited to a serous and poorly defined cellular infiltration, for the bac-teria quickly pass through the lymphatics to the peritoneum or into theblood stream. Fortunately for the protection of the individual, in mostcases there is an adequate protective tissue reaction zcith the formation oflarge exudates. Section through these masses shows the lymph vessels 88 PELVIC INFLAMMATION IN WOMEN thickenedT tortuous and beaded, and a yellowish or whitish pus exudesfrom numberless minute openings. The lymphatic chains are surroundedwith exudate, giving them a glistening, glassy, moist appearance. Theveins are often thrombotic, either from primary infection, or they maybecome secondarily infected and the thrombi may undergo puriformdegeneration, the debris breaking up and getting into the circulation,forming infected emboli. As the exudate increases in amount the blood supply is increased. Thisis especially apparent on the venous side, and later as cicatricial tissue. Fig. 32.—As the Exudate Organizes and the Scar Tissue Contracts, the UterusIs Drawn Toward the Side of the Exud.\te, forms and the scars shrink; the arteries are kinked and varicosities occurin the veitis, while the ganglia and nerves may become pinched in thecontracting cicatrices. This explains the pain and the frequency of pelvicvaricosities in patients who give a history of an infected with the pouring out of exudate into the cellular tissues inthe broad ligaments subperitoneally, there is an edema, and necessarilythe pelvic peritoneum takes part in the inflammation and throws out anexudate upon its surface, which causes the tubes and ovaries to becomematted together and adherent to the broad ligaments, uterus, or theintestines, clinically giving the impression of large exudate masses. Consequently it may be stated that parametritis ahcays excites some PUERPERAL INFECTIONS 89 degree of perimetritis. This inflammatory exudate
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