. Atlas and epitome of gynecology . and then continuous, with exacerbations similar to the pains of labor; vesical and rectal disturbances; indiges-tion and vomiting, due to thepressure of the accumulatedblood. Hematosalpinx oc-curs in uterine atresiasearlier than in those of thevagina. (Plate 40, Fig. 2.)It is dangerous on accountof the ease with which thetubal wall may be torn,and consequently the ex-amination should be con-ducted with great gentle-ness. The peritoneum is frequently subjected to inflammatory irritation by the escape of small quantities of blood from the tubal ostia. The same
. Atlas and epitome of gynecology . and then continuous, with exacerbations similar to the pains of labor; vesical and rectal disturbances; indiges-tion and vomiting, due to thepressure of the accumulatedblood. Hematosalpinx oc-curs in uterine atresiasearlier than in those of thevagina. (Plate 40, Fig. 2.)It is dangerous on accountof the ease with which thetubal wall may be torn,and consequently the ex-amination should be con-ducted with great gentle-ness. The peritoneum is frequently subjected to inflammatory irritation by the escape of small quantities of blood from the tubal ostia. The same dangers exist in collections of blood in closed rudimentary cornua. In unilateral atresia of a double genital canal (uterus septus cum vagina septa) we have less to fear, as the hematoma is more likely to rupture into the patulous side. (Figs. 10 and 11.) The bloody tumor may undergo putrefactive or sup-purative changes. When only one genital canal exists, rupture commonly occurs through a thinned-out por-tion of the cervix. The. Fig. 14.—The two Miillerianducts have fused to form theuterus ( U); a septum still existsin the fundus. The sinus uro-geuitalis is longer (S. u.). G =genital eminence = future cli-toris ; Pe — perineum. The ure-thra opens high up, and is stillmore marked than the genitalcanal. blood may escape into the peritoneal cavity (peritonitis) or beneath the peritoneum,extending down around the vagina to the floor of thepelvis—hsematoma vulvae or vaginae. ATRESIAS. 27
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