Gynaecology for students and practitioners . convolutions of luteintissue have not been subjected to enoughpressure from contained blood to causethem to be flattened out. Under normal conditions, as soon as the follicledehisces and the ovum escapes, the vascularity of the theca internasubsides, and blood escapes only in sufficient amount to take the placeof the liquor folliculi. In chronic oophoritis the congestive state of thetheca interna is not thus easily relieved, but may lead to ovulationbeing accompanied with severe internal hsemorrhage. In such cases,therefore, the blood comes from the
Gynaecology for students and practitioners . convolutions of luteintissue have not been subjected to enoughpressure from contained blood to causethem to be flattened out. Under normal conditions, as soon as the follicledehisces and the ovum escapes, the vascularity of the theca internasubsides, and blood escapes only in sufficient amount to take the placeof the liquor folliculi. In chronic oophoritis the congestive state of thetheca interna is not thus easily relieved, but may lead to ovulationbeing accompanied with severe internal hsemorrhage. In such cases,therefore, the blood comes from the periphery of the corpus luteum(theca interna) and not from the ovarian cortex lacerated by hsematomata of the ovary are lined by lutein tissue ; sometimes,however, the hsemorrhage may not be circumscribed, but we find itdiffused into the stroma, where blood may collect in sufficient amountto produce a hsematoma the size of an egg. This diffuse hcematoma isnot so commonly met with as are circumscribed or lutein Fig. 364. Lutein in its tranverse axis. NEW GROWTHS OF THE OVARY 659 As the latter is caused by chronic oophoritis it is not surprising to findthat hsematomata are often bilateral, and are often very adherent andaccompanied by chronically thickened tubes. They are liable tosecondary infection, and form one of the precursors to ovarian abscesses{see Figs. 351 and 352, p. 647). Hsematomata derived from theca-lutein cysts have thick walls,they may attain the size of an orange {see Fig. 364), the contained bloodmay be inspissated and resemble anchovy paste, or may form a thicktarry syrup. Except in the largest cysts, lutein tissue, as a fiat lamina,may be made out underneath an inner fibrinous lining. Ovarianhsematomata have to be diagnosed from ovarian gestation, and thisespecially applies to the hsematoma derived from a mature examination for chorionic villi will be necessary to settlethe diagnosis. A su
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
