. The diagnosis and treatment of diseases of women. iTs^mim :,.*.l.^i «sts KlliScliiivoas r;i,^^^^^H i -^tt| w» Plfgifiaiii :^nJ^^H I 1 -i+f- ? 1 ^^ Fig. 195. Ascites and Tumor. Area of Dullness with patient Stand-ing. Same patient as shown in Fig. 194. Notice the marked change inthe upper limit of the dullness. It is now almost horizontal. The formermarks have not been completely removed. situated in the center or laterally or may fill the whole abdomen. There isdullness over that portion of the mass lying against the abdominal wall and reson-ance elsewhere, unless there is associated ascites
. The diagnosis and treatment of diseases of women. iTs^mim :,.*.l.^i «sts KlliScliiivoas r;i,^^^^^H i -^tt| w» Plfgifiaiii :^nJ^^H I 1 -i+f- ? 1 ^^ Fig. 195. Ascites and Tumor. Area of Dullness with patient Stand-ing. Same patient as shown in Fig. 194. Notice the marked change inthe upper limit of the dullness. It is now almost horizontal. The formermarks have not been completely removed. situated in the center or laterally or may fill the whole abdomen. There isdullness over that portion of the mass lying against the abdominal wall and reson-ance elsewhere, unless there is associated ascites. There is no decided change ofoutline of the dullness with change of position of the patient. The growth mayspring from the uterus (Fig. 199) or from the ovary or broad ligament. Thelatter growths are usually situated well to one side at first but later may fillthe whole lower abdomen. Usually in such a growth there is still a corona ofresonance surrounding the upper part of the growth and extending well into each 12 164 GYNEC0L0GIC2DIAGN0SIS. Fig. 196. Ascites and Tumor. Same patient as shown in Fig. Two Areas Contrasted. The soUd Une shows the border of the dullarea when the patient is on her back and the dotted line when she isstanding. The change of outline of the dullness on change of postureis very evident, making it beyond doubt that, whatever other abnormalcondition there may be in the abdomen, there is certainly free fluidNotice also that as the patient stands the upper margin of the dull area(dotted line) is approximately horizontal.
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