Pathology and treatment of diseases of women . iae and their peritoneal covering, and roll in-wardly, and thus there soon arises a complete closure of the abdominaltubal ostium. In other cases the fimbriae do not become agglutinatedand adherent to each other, but to the neighboring parietal perito- DISEASES OF THE UTERINE TUBES 335 neum of the excavatio recto-uterina, the intestinal loops, especially thesigmoid flexure, through which also a closure of the tubal ostium end results, the closure of the abdominal tubal extremity, is thesame in both of the processes just described. The
Pathology and treatment of diseases of women . iae and their peritoneal covering, and roll in-wardly, and thus there soon arises a complete closure of the abdominaltubal ostium. In other cases the fimbriae do not become agglutinatedand adherent to each other, but to the neighboring parietal perito- DISEASES OF THE UTERINE TUBES 335 neum of the excavatio recto-uterina, the intestinal loops, especially thesigmoid flexure, through which also a closure of the tubal ostium end results, the closure of the abdominal tubal extremity, is thesame in both of the processes just described. The result of it is an ac-cumulation of the always continuously produced purulent secretion and adistention of the tubal walls, which finally leads to a formation of atubal sac filled with pus, sactosalpinx purulenta, pyosalpinx (seeFig. 148). In this stage the process has already passed from the acuteto the chronic stage. In place of the round cell infiltration there occursa chronic connective tissue proliferation, which thickens the tubal walls. Fig. 149.—Salpingitis Purulenta. (Authors preparation. Zeiss, Obj. AA, Oc. 2.) to many times their normal condition. The entire organ becomes ser-pentine, the folds coalesce with each other, so that the most fantasticforms may result as larger and smaller, richly sinuated sacs, also moresausage-shaped, thick-walled formations, as also rosarylike forms, if theconnective tissue proliferation has acted more intensively in some latter are termed salpingitis isthmica nodosa. The acute endo-salpingitis has become a chronic pansalpingitis. Microscopically the mucous epithelium is found mostly destroyed,the naked tubal folds are covered with granulation tissue and projectinto the pus-filled lumen. The folds are, however, no longer so fine butcoarser, lower, and torn asunder by the internal pressure; with it existfoci of round cell infiltration in the entire wall, especially around thevessels (see Fig. 149). 336 DISEASES OF WOMEN The
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Keywords: ., bookcentury1900, bookdecade1, booksubjectgynecology, bookyear1912
