Gynecological diagnosis and pathology . he cervix or from the rectum. The latter source accountsfor the not infrequent cases in nulliparous women. As the result ofcicatrisation following the inflammation, shortening of the ligamentsoccurs. The uterus is thus pulled on at the junction of the body andcervix, and the condition of acquired anteflexion produced (fig. 182—seealso fig. 31). The uterus as a whole is pulled back in the pelvis whilethe forward inclination of the body on the cervix is exaggerated. It is acondition frequently met with and presents characteristic symptoms and 190 GYNECOLOG
Gynecological diagnosis and pathology . he cervix or from the rectum. The latter source accountsfor the not infrequent cases in nulliparous women. As the result ofcicatrisation following the inflammation, shortening of the ligamentsoccurs. The uterus is thus pulled on at the junction of the body andcervix, and the condition of acquired anteflexion produced (fig. 182—seealso fig. 31). The uterus as a whole is pulled back in the pelvis whilethe forward inclination of the body on the cervix is exaggerated. It is acondition frequently met with and presents characteristic symptoms and 190 GYNECOLOGICAL PATHOLOGY physical signs. The common symptom is pain over tbe sacral regionaggravated at the menstrual periods and on exertion, sometimes especiallyon defalcation. On vaginal examination, the cervix is far back in thepelvis. The external os is frequently directed forwards as in careful bimanual examination, however, the fundus is felt lying tothe front, and the finger can be placed in the angle of flexion between. Fig. 182.—Section of Pelvis showing Displacement produced byUtero-sacral Cellulitis.—(Berry Hart.) Note thickening of utero-sacral ligament and acute anteflexion of uterus, which(is also drawn back in the pelvis. it and the cervix. • Through the posterior fornix the tense utero-sacralligaments are felt stretching towards the sacrum. If they are notdistinctly palpable they can be rendered so by pressing the cervix frombehind towards the symphysis pubis. The ligaments can then be feltas tense bands, and at the same time the patient complains of per rectum is of service where it is difficult to recognisethe position of the uterus bimanually. PELVIC HEMATOCELE. This term is applied to haemorrhage into the peritoneal cavity shutoff by adhesions. Free internal hemorrhage usually results in the deathof the patient. The limiting adhesions produce a distinct tumour similarto the peritonitic exudation shown in fig. 179. The term hem
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
