Identifier: atlasepitomeofgy00scha (find matches)
Title: Atlas and epitome of gynecology
Year: 1900 (1900s)
Authors: Schaeffer, Oskar. (from old catalog) Norris, Richard Cooper, 1863- (from old catalog) ed
Subjects: Women
Publisher: Philadelphia, W. B. Saunders & company
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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ent.The anterior surface of the ovary is embedded in thebroad ligament (by the mesovarium), while the posteriorsurface, directed toward the pouch of Douglas, is uncov-ered. If an ovarian cyst develops from the anteriorsurface, it grows into the connective tissue between thetwo layers of the broad ligament—it is intraligamen-tous ; if the tumor becomes larger, it strips up the pos-terior lamella, elevates the serosa of Douglas pouch, andreaches the spinal column—it becomes retroperitoneal/ The pedicle previously mentioned is pathognomonic ofovarian tumors, and may be demonstrated by the methodillustrated in Plate 74. It is usually twisted in a spiralmanner in the larger tumors. This torsion of the pedicleis due to intestinal peristalsis, to the variable emptying andfilling of the abdominal organs, and to the movements ofthe body. In left-sided tumors the pedicle is morefrequently twisted from 90 to 180 degrees to the right.If it is twisted more than 360 degrees, disturbances of the
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SEQ UELS. —SYMPTOMS. 213 circulation and extravasation occur in the tumor, andhematomata are formed in the pedicle ; secondary dis-turbances of nutrition lead to retrograde metamorphoses ;both results are serious in proportion to the rapidity ofthe compression (necrosis ; rupture of the mucoid degen-erated wall, Plate 72 ; decomposition ; peritonitis). Ifcolloid masses reach the peritoneal cavity, they becomeorganized upon the serosa, constituting peritoneal myx-edema (pseudomyxoma peritonei, Werth). The larger tumors always cause fibrinous deposits andadhesions, because the changed superficial epithelium be-comes desquamated. In a beginning cystoma the fim-briated end of the tube sometimes becomes agglutinated ;if the dividing wall disappears, a tubo-ovarian cyst re-sults. 3. Papillary proliferating cysts. (See explanation to Fig. 61.) 4. Racemose cysts (Olshausen) differentiate themselves from thecystadenomata by the fact that several vesicles are attached to onepedicle; even if t

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