Gynaecology for students and practitioners . us abscess should never be drained per vaginam, as an intractablefistula always results. Tuberculosis of the Peritoneum. Tuberculosis of the peritoneumis commoner in women than men. The peritoneum of the pelvisis the part frequently affected most, a fact which has been attri-buted to the gravitation of tubercle bacilli to the bottom of theperitoneal cavity. Williams attributes peritoneal infection to a pelvicsource in from 40 to 50 per cent, of cases. Abbe considers that 66 per 1 i TUBERCULOSIS OF THE GENERATIVE ORGANS 315 cent, of the cases are inf
Gynaecology for students and practitioners . us abscess should never be drained per vaginam, as an intractablefistula always results. Tuberculosis of the Peritoneum. Tuberculosis of the peritoneumis commoner in women than men. The peritoneum of the pelvisis the part frequently affected most, a fact which has been attri-buted to the gravitation of tubercle bacilli to the bottom of theperitoneal cavity. Williams attributes peritoneal infection to a pelvicsource in from 40 to 50 per cent, of cases. Abbe considers that 66 per 1 i TUBERCULOSIS OF THE GENERATIVE ORGANS 315 cent, of the cases are infected from the thoracic glands, and 16 percent, through the mesenteric glands. The intestine and the blood-stream are other sources of infection. Varieties. There are three types to be distinguished : (1) themiliary, (2) the caseous, (3) the fibroplastic. (1) The Miliary Form. This form may exist for a long timewithout causing symptoms. The peritoneum is covered with minutetubercles {see Fig. 152). There may or may not be adhesions Fig. 152. Showing Miliary Tuberculosis of the Pelvic Peritoneum. (Clifford White.) In the acute form the peritoneum is thickened and lustreless, andflakes of lymph, like opaque curds, adhere to the surface. There isa variable amount of ascites ; the fluid is yellow or blood-stained,and may contain masses of floating lymph. In this type adhesionsare frail and easily bleed. (2) The caseous form is much more severe ; caseous masses andabscesses exist, the intestines and omentum may form an adherentmass which feels like a neoplasm on physical examination. Betweencoils of adherent bowel encysted collections of yellow, caseous, orpurulent fluid may be found. Such a condition may be localized tothe pelvis or to the omentum or elsewhere, or a general ascites mayexist. There is a danger in the caseous form of fistulm forming andopening into bowel or bladder or at the umbilicus. When localizedto the pelvis, tuberculous peritonitis is practically alwa
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
