Outlines of the diseases of women / by John Phillips.

  • Phillips, John.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Outlines of the diseases of women / by John Phillips. Source: Wellcome Collection.

    189/332 (page 169)
    and consists in opening the abdomen by a very free incision, turning out the tumour, and tying the broad Hgaments so as to control lueniorrhase ; the base of the tumour is then surrounded, usually at the site of the internal os uteri, with a serre-nceud held by means of a clamp, which tightens up the loop: the growth is then cut away, the stump brought out at the abdominal wound, and the incision closed; the portion above and a certain amount below the clamp will slough away, and the cervix thus becomes firmly attached to the posterior surface of the abdominal wall; this is the extra-peritoneal method and the safest. In the intra-peritoneal method, the broad ligaments are ligatured and the mass cut away as before, but instead of bring- ing the stump out at the abdominal opening, the peritoneum is brought over the flaps, which are sewn together and the stump dropped into the pelvic cavity. There is great risk of haemor- rhage, and although it is surgically correct treatment it is less frequently resorted to. This operation is often very difficult or inadvisable where the fibroid involves the cervix, the formation of a pedicle being then impossible. Practical deductions— 1. If a tumour be submucous (pediculated or sessile), remove it after the method given on page 165. 2. If it be subserous (pediculated or sessile), but quiescent, leave it alone. 3. If interstitial or a sessile subserous (growing), try prolonged palliative treatment, then Apostoli's method. 4. If this fail, dilatation of the cervix. 5. Finally, removal of the ovaries, or hysterectomy. Uterine Polypi. Much confusion has always surrounded the nomenclature of these growths. They may be classified as follows: 1. True or mucous. 2. Spurious, which may be— a. Malignant polypus; /3. Fibrinous polypus; y. Placental polypus. 3. Submucous fibro-myomata which have become pediculated {vide p. 164) = fibroid polypi. Definition.—A uterine polypus is a tumour covered by uterine mucous membrane; it is attached to the uterus by means of a