. An American text-book of obstetrics. For practitioners and students. Puerperal Sepsis.—The latest development in celiotomyfor puerperal sepsis is the removal of all the pelvic organs and structures thatcan be removed when the septic inflammation or suppuration involves theuterine muscles and the broad ligaments. Every physician who has seen manycases of puerperal infection during operations or post-mortem is aware that thereare some in which the mere removal of infected tubes and ovaries or the evac- OBSTETRIC SURGERY. 973 nation of pelvic abscesses cannot be expected to save the patient. Th
. An American text-book of obstetrics. For practitioners and students. Puerperal Sepsis.—The latest development in celiotomyfor puerperal sepsis is the removal of all the pelvic organs and structures thatcan be removed when the septic inflammation or suppuration involves theuterine muscles and the broad ligaments. Every physician who has seen manycases of puerperal infection during operations or post-mortem is aware that thereare some in which the mere removal of infected tubes and ovaries or the evac- OBSTETRIC SURGERY. 973 nation of pelvic abscesses cannot be expected to save the patient. There wouldbe left behind areas of infected and infiltrated broad ligaments that wouldsurely communicate infection to the peritoneal cavity, or there would remainfoci of suppuration or infection in the uterine body that must surely spread tothe peritoneum or must result in septic metastases. The only hope for thepatient in such cases lies in the entire removal of all infected areas, leavingbehind in the pelvis a healthy, non-infected stump. To effect this result the. Fig. 577.—Hysterectomy fur purulent salpingitis (Hirst). excision of the uterus, the broad ligaments, the tubes, and the ovaries is re-quired. In addition to these cases there are others in which, if the tubes andovaries must be excised, the uterus might be removed with advantage, onaccount of an infected endometrium or of persistent metrorrhagia. Figure577 is an example of such a case. The young woman from whom the speci-men was removed had a double pyosalpinx following a criminal abortion. Forseven weeks she had been bleeding persistently and at intervals had a foul- 1
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectobstetrics, bookyear1
