Operative gynecology : . of a pyometra, probably due to the pres-ence of gas-producing bacilli. I have seen but three cases of physometra, two complicating large sloughingsubmucous fibroids, and one associated with a pyometra due to a cancerouscervix. PHYSOMETRA. 663 Physometra Due to Cancer.—The patient was a black woman, sixty-one years of age, sent me by Dr. C. M. Cheston, of West Eiver, Md., in July,1890. Although she ceased to menstruate ten years before, she had had hemor-rhages for two years. She had no leucorrhea, but complained of a burningfeeling across the back and abdomen, and the
Operative gynecology : . of a pyometra, probably due to the pres-ence of gas-producing bacilli. I have seen but three cases of physometra, two complicating large sloughingsubmucous fibroids, and one associated with a pyometra due to a cancerouscervix. PHYSOMETRA. 663 Physometra Due to Cancer.—The patient was a black woman, sixty-one years of age, sent me by Dr. C. M. Cheston, of West Eiver, Md., in July,1890. Although she ceased to menstruate ten years before, she had had hemor-rhages for two years. She had no leucorrhea, but complained of a burningfeeling across the back and abdomen, and the hemorrhages, which continued,as a rule, for two days, were followed by a watery discharge. She had severaltimes been insane. The cervix was high up in the vagina and fixed to the left pelvic wall;on its right side, easily felt through the vagina and thin abdominal walls, wasa globular fluctuant tumor, about 10 cm. (4 inches) in diameter. The cervixwas the seat of a cancerous degeneration measuring 3 cm. (1-j inches) in. Fig. 374.—Pyophysometra Due to Occlusion of the Cancerous Cervix. Note the thin distended uterine wall, containing pus in the lower part of its cavity, with a largegas space above. An explosion of gas took place as soon as the instrument broke through the barrierat the cervix. diameter, from which numerous shreds of tissue hung down into the vaginawith excavated areas between them, freely bleeding when touched. The cancer-ous tissue was first broken down with the fingers, followed by a sharp curette, 664 THE UTERUS AS A RETENTION CYST. and the base, which was superficial, was thoroughly cauterized; it appeared tobe one of the slow-growing cancers of old age. On making a bimanual examination to locate the fundus, the vaginalfinger suddenly entered a large smooth cavity, and this was signalized by anaudible report like the pop of a gun, with a rush of gas out of the sac, followedby 90 of thick, intensely fetid pus (pyophysometra). (See Fig. 374.) The body
Size: 1578px × 1583px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, booksubjectgynecology, bookyear1
