. Operative gynecology. cases; thus, amongthirty - six multilocularcysts which I have op-erated upon, twenty-two of them presentedno adhesions at all,while fourteen were ad-herent in varying de-grees from a few lightomental attachments allthe way to extensiveparietal, intestinal, andpelvic adhesions. The omentum ismore apt to contractadhesions with the cystwall than any otherabdominal organ, andthese adhesions may bein the form of one or more long ri?>bons attached to the tumor at the lowerend, or the whole free border of the omentum may be adherent. Formerly, when tapping was resorted to,
. Operative gynecology. cases; thus, amongthirty - six multilocularcysts which I have op-erated upon, twenty-two of them presentedno adhesions at all,while fourteen were ad-herent in varying de-grees from a few lightomental attachments allthe way to extensiveparietal, intestinal, andpelvic adhesions. The omentum ismore apt to contractadhesions with the cystwall than any otherabdominal organ, andthese adhesions may bein the form of one or more long ri?>bons attached to the tumor at the lowerend, or the whole free border of the omentum may be adherent. Formerly, when tapping was resorted to, adhesions were found quite uni-formly between the abdominal parietes and the cyst wall at the point of the cyst walls are thin and the accumulation of fluid rapid, the wall ofthe largest cyst may rupture, allowing the contents to escape into the abdomi-nal cavity. Where this occurs, the smaller cysts develop rapidly, project intothe rent produced in the large cyst, and eventually completely obliterate Fig. 410.— The Wall of a Multilocular 0\arian Cist magnified170 Times, showing the Secreting Glandular Spaces and theMethod of Kormation of Pseudomucin. In the large space on the right the lining epithelial cells are seen invarious stages, from those which are inarkeiily granular and contain nopseudomucin, to those in which the cell contents are lighter; and, tiiially,those in which a goblet cell has been formed full of pseudomucin, andeven bursting into the cyst. Spec. 538. 364 OVARIOTOMY. The escape of fluid into the abdomen may be followed by a condition calledp seudo - my xomat ous peritonitis. The growth of these cysts is usually rapid—in general more rapid than thatof the parovarian cysts, although the initial stages are never noted; thus, outof thirty-five cases, the growth is noted as rapid in twenty-three, gradual inseven, and slow in but five, and out of these five two had ruptured and decreasedin size and then reappeared. The longest duration not
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