. Tumours, innocent and malignant; their clinical characters and appropriate treatment. Fig. 103.—Section of a uterus from which a sloughing fibroid had been mucous membrane was gangrenous, and infective material had leaked intothe coelom through the unclosed ostium. the peritoneal cavity through an unclosed ostium, and estab-lishes fatal peritonitis (Fig. 103). An extruded fibroid often becomes septic, for, when thetumour passes beyond the external orifice of the uterus, 190 GONNEGTIVE-TISSUE TUMOURS the part lying within the canal is firmly grasped by the ute-rine walls bounding
. Tumours, innocent and malignant; their clinical characters and appropriate treatment. Fig. 103.—Section of a uterus from which a sloughing fibroid had been mucous membrane was gangrenous, and infective material had leaked intothe coelom through the unclosed ostium. the peritoneal cavity through an unclosed ostium, and estab-lishes fatal peritonitis (Fig. 103). An extruded fibroid often becomes septic, for, when thetumour passes beyond the external orifice of the uterus, 190 GONNEGTIVE-TISSUE TUMOURS the part lying within the canal is firmly grasped by the ute-rine walls bounding the internal orifice. Should the tumourbe very vascular, the venous circulation is interfered with, andthe projecting part becomes cedematous. Should the com-pression continue, the extruded parts become congested, andmay even necrose, and as the dead tissue is in a situationeasily accessible to air, and consequently to putrefactiveorganisms, gangrene, with all its attendant evils, is the is always necessary, in examining fibroids projecting into. Fig. 104:.—Partial inversion of a uterus due to a fibroid. the vagina, to be careful to distinguish between the fundusof an inverted uterus and a fibroid extruded from the uterus,and at the same time to remember that a submucous fibroidwill occasionally invert the uterus (Fig. 104). Sepsis plays an important part in haemorrhage associatedwith cervical fibroids. Professional opinions on this matterare very divergent, and after a careful study I am able to statethat menorrhagia and metrorrhagia are only associated withthe intracervical variety of fibroids and bear no relation tothe size of the tumour; but hsemorrhages only occur withthe intracervical fibroids when the uterus has made attemptsto extrude, or has succeeded in extruding, the tumour wholly UTERINE FIBROIDS 191 or partially into the vagina. The corollary is obvious. Anextruded or partially extruded fibroid quickly becomes septic,and as surely as this happens meno
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectneoplasms, bookyear19
