Gynaecology for students and practitioners . ee Fig. 157). The site of invasion is difficult tolocate clinically, the part of the pelvis in which the mass lies being oftenthe only point which can be determined with certainty. The presenceof a mass in the liver, or the history of a previous operation for hydatidsof the liver, would afford strong presumptive evidence of a pelvicswelling being echinococcal in origin. After rupture of the cyst therewill be a history of sudden disappearance of the swelling, with possiblysymptoms of serous peritonitis, marked eosinophilia, and transienturticaria (Ba
Gynaecology for students and practitioners . ee Fig. 157). The site of invasion is difficult tolocate clinically, the part of the pelvis in which the mass lies being oftenthe only point which can be determined with certainty. The presenceof a mass in the liver, or the history of a previous operation for hydatidsof the liver, would afford strong presumptive evidence of a pelvicswelling being echinococcal in origin. After rupture of the cyst therewill be a history of sudden disappearance of the swelling, with possiblysymptoms of serous peritonitis, marked eosinophilia, and transienturticaria (Barling and Welsh). Treatment. As the pelvic condition is often not the only mani-festation of hydatid disease, the surgeon must be prepared to dealwith abdominal lesions as well, in the experience of one of us 330 GYNECOLOGY the cysts had burrowed behind the diaphragm and extended as highas the left axilla, whilst below it depressed the pelvic floor and bulgedinto the vagina. The treatment of hydatids consists in the removal of the cyst. „6 ™_d Fig. 158. Hydatid (Echinococcal) Cyst of the Fallopian Tube, a, Cystb, Closed abdominal ostium, c, Lumen of tube laid open, d, Ovary, e, Meso-salpinx. The cyst has formed in the subperitoneal cellular tissue of theupper wall of the tube. or cysts. The removal should be complete whenever possible. In acertain number of cases only partial removal can be carried out, theadventitious pericyst having to be left behind. STREPTOTHRIX INFECTIONS 331 (1) Complete Removal of the Cyst. Hydatids of the uterus, ovaries,tubes, and broad ligaments are best treated by this method. Simplecysts should be aspirated before incising the pericyst. (2) Partial Removal of the Cyst. This consists in opening the pericystand scraping away the entire endo- and ecto-cyst in order to destroythe parasite. The operation is concluded in one of two ways : {a) Bystitching the cut edges of the pericyst to the parietes and insertinga drain {marsupialisation) or (6)
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
