Essentials of gynecology : arranged in the form of questions and answers prepared especially for students of medicine.

  • Cragin, Edwin B.
Date:
1913
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Licence: Public Domain Mark

Credit: Essentials of gynecology : arranged in the form of questions and answers prepared especially for students of medicine. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    How would you differentiate pelvic cellulitis from salpin- gitis ? By a careful bimanual, in a case of salpingitis, you can generally map out an enlarged, tortuous tube, usually distended, extending from the side of the utenis to the region of the ovary ; if distended with fluid, you may detect fluctuation. It does not bulge into the vagina as does celluhtis. The history of the case is of value in the diagnosis. What is the treatment of pelvic cellulitis ? 1. Prophj'lactic :— Strict cleanliness and antiseptic precautions during labor, abortion, operations, etc. 2. Abortive :— Put patient to bed. apply cold to the lower portion of abdomen. 3. When exudation has occurred :— Apply heat to the abdomen, admhiister hot-water vaginal douches, move bowels, and attend to the general health. 4. If the exudation suppurates:— As soon as pus is detected, incise under antiseptic precautions and drain. The two most favorable sites for incision are through the vagina and through the abdominal wall just above Poupart's liga- ment. In doubtful cases it is sometimes advisable to open the abdomen in the median line, and then determine by the relations of the mass, the best mode of procedure. This, however, is rarely necessarj^ Septic Thrombo-phlebitis. Define. This is one of the anatomical forms of puerperal infection. It may also follow instrumentation or trauma. The phlebitis may in- volve a single vein, as the ovarian, or be widely disseminated through the pelvic veins and extend into the inferior cava. What are the symptoms ? It is difficult to diagnose the condition in its earliest stages when we might hope to find the process limited to the broad ligament veins. There will be a history of abortion, labor or use of instru- ments ; there may be retained placenta. Tlie temperature ranges from subnormal to very high, with abnipt changes in either direc- tion. Chills may be expected with frequent recurrence. Bacteria