Gynecological diagnosis . entCleveland operated with my assistance January 20, 1890. Thepatient had been married one year and had not been had very few symptoms. The right tube measured six inchesin length, and three inches in diameter at its outer end, and onemikI three-fourths inches at its inner end. Three inches of the RETENTION TUMORS OF THE TUBE 333 isthmian end of the tube were not enlarged. This tube had com-paratively few adhesions about it. The left tube measured fourinches in length, and three inches in diameter, and the surroundingadhesions were dense. Each was ovoid i
Gynecological diagnosis . entCleveland operated with my assistance January 20, 1890. Thepatient had been married one year and had not been had very few symptoms. The right tube measured six inchesin length, and three inches in diameter at its outer end, and onemikI three-fourths inches at its inner end. Three inches of the RETENTION TUMORS OF THE TUBE 333 isthmian end of the tube were not enlarged. This tube had com-paratively few adhesions about it. The left tube measured fourinches in length, and three inches in diameter, and the surroundingadhesions were dense. Each was ovoid in shape and showed noconvolutions. As a rule a pus tube is surrounded by adhesions, because itsperitoneal surface is enveloped in an inflammatory pus is sterile in over half of all cases. This fact is explained bythe dying out of the microorganisms which have caused the inflam-mation and are always to be found in the acute and subacute walls of a pyosalpinx are generally thick, but they may be Fig. 137.—Pyosalpinx. In the older cases the epithelial lining of the tube has been replacedby granulation tissue. Rupture into the peritoneal cavity is anaccident which has occurred, although not very commonly. C. {Surgery, Gynecology, and Obstetrics, Nov., 1909, p. 542)collected forty-five cases, including the cases from the literatureand a case of his own. In most instances there was no assignablecause for the rupture. Whenever infection has set up an abscessof the ovary as well as a pyosalpinx the condition is known as atubo-ovarian abscess. This has been described under Pelvic Abscess.(See Chapter XII, page 193.) The diagnosis of pyosalpinx will be considered with the diag-nosis of hydrosalpinx and hematosalpinx. Hydrosalpinx is an accumulation of serous fluid in the tube. It 334 DISEASES OF THE FALLOPIAN TUBES presupposes complete closure of the ostium abdominale, but notnecessarily the lumen of the isthmus of the tube, and is the resultof a
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