1899 American Journal of the Medical Sciences  
OF NEW YORK. Torsion of Parovarian Cysts.-Bouilly {La Gynecologic, December 15, 1898) calls attention to the rare occurrence of torsion of the pedicle in true parovarian cysts, and to the fact that, while the clinical Bymptoms are the same as those which result from this accident in the case of ovarian neo¬ plasms, the anatomical changes in the cyst itself are much less marked. Instead of the extreme congestion, intra-cystic hemorrhage, and necrotic changes observed in ovarian cystomata,
more » ... parovarian cysts may pre¬ sent a nearly normal appearance, the contents being unchanged. This dif¬ ference is explained by the greater thickness of the pedicle in the case of the latter, so that the circulation is not interrupted, while the vascularity ib also less. The writer reports two cases which presented typical symptoms of torsion, yet on opening the abdomen non-pedunculated parovarian cysts were found, the walls of which showed evidences of necrotic changes, one of them containing old blood-clots. He was unable to explain the condition unless on the theory of traumatism, or necrobiosis of the cyst-wall and rup¬ ture of its vessels due to pressure or torsion of the broad ligaments, both of which were unsatisfactory. Intra-abdominal Shortening of the Round Ligaments.-Doleris {La Gynecologic, December 15,1898) reports seven successful cases operated upon by his method, which is briefly as follows: After separating adhesions and removing one or both adnexa if necessary, both round ligaments are caught with forceps or ligatures at points midway between the uterine cornua and the internal rings, and the two loops thus formed are brought up to the lower angle of the abdominal wound, where they are secured by sutures of silk or catgut, which include the peritoneum, muscle, and fascia. The abdomen is then closed in the usual manner. Early Diagnosis of Cancer of the Uterus.-HeitzjiAnn (<Ccntralbl. fur die get. Therapic, July, 1898) emphasizes the fact that pain, metrorrhagia, and foul discharges are late symptoms of malignant disease of the uterus, which often mark the inoperable stage. Hence the necessity of recognizing the presence of carcinoma before these appear. He calls attention to an impor¬ tant aid to diagnosis, which he first published twenty years ago. If a pledget of cotton soaked in a 10 per cent, solution of sulphate of copper be applied for a minute or two to a suspicious erosion on the portio vaginalis the sur¬ face will become quite blanched if it is a mere ectropion. If it is a simple erosion a thin, bluish-white coating will form, without hemorrhage. By repeating the applications at intervals of three or four days the erosion will be entirely healed at the end of a fortnight by the ingrowth of squamous epithelium from the periphery of the raw surfaces.
doi:10.1097/00000441-189905000-00011 fatcat:oyuoeglgsjem3kqahjihbpeqfy