Identifier: principlespracti00dudl (find matches)
Title: The Principles and practice of gynecology : for students and practitioners
Year: 1904 (1900s)
Authors: Dudley, E. C. (Emilius Clark), 1850-1928
Subjects: Gynecology
Publisher: Philadelphia : Lea Brothers & Co.
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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e away through an aspirator or trocar.^ Degenerative processes may cause rupture of the cyst and dis-charge of its characteristic vesicles, booklets, or membranes throughthe vagina, rectum, or bladder; the diagnosis is then clear. Hydatidcysts are rare. 1 Sutton. Surgical Diseases of the Ovaries and Fallopian Tubes. SECONDARY CHANGES. 453 DifFerentiation of Renal Tumors and Ovarian Cysts. The distinction between renal tumors and other alxlominal andpelvic enlargements is often extremely difficult. They have beenrepeatedly mistaken, not only for ovarian tumors, but as well fortumors of the pancreas, liver, spleen, intestine, omentum, and uterus.A\ ithout an exploratory incision, the greatest care and the widestgeneral knowledge may be inadequate to a diagnosis. The enlargedkidney has been found, not only so loose as to occupy almost anylocation or position in the abdomen or pelvis, but fixed by adhesionsin its mal-location—for example, to the pelvic brim or to the sacrum. Figure 207.
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Left kidney in the hollow of the sacrum ; the renal artery and vein are dragged down withthe kidney producing a mechanical disturbance in the urinary system and in the circulationwhich would necessarily have serious results In such cases the clinical history and rational signs—includingurinalysis—usually will give evidence of renal disease. A renal cystmay be hydronephrosis or pyelonephrosis. The differentiation ismade as follows : Hydronephrosis. 1. Enlargement unilateral and from abovedownward. Growth fixed in region of kidney. 2. Expression unchanged. 3. Growth usually slow. 4. Intestines may be in front of tumor. 28 Ovarian cysts. 1. Enlargement at first unilateral: later sym-metrical and from below upward. No fixation. 2. Facies ovariana. 3. Growth relatively rapid. 4. Intestines in the flanks above and back oftumor. 454 TUMORS, TUBAL PREGNANCY, MALFORMATIONS. Hydronephrosis. 5. Fluid not necessarily albuminous; maycontain calculi. 6. Vaginal touch negative. 7. Urine may cont

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