nocoif negeyl
|
 |   Related post: 5. Hydrosalpinx may be treated by mechanical or surgical means. 6. The former will consist in relieving a displaced uterus and so cor- recting the position of the tube. This may lead to the evacuation of the tubal tumor through the uterus. Or massage may be used to ad- vantage in some cases associated with baths and irrigation per vaginam. It is dangerous to treat this condition by sounding the tube, more par- ticularly if a stiff sound is used, and only this form would be efficient. Dilatation of the uterus is likewise not free from danger ; it may result in producing a pyosaipinx. 7. Surgical means are indicated when mechanical ones fail, and they should aim to treat the tube and ovary as far as possible by conserva- tiye measures. Puncture may be employed through the vagina with antiseptic precautions, the tumor being pushed downward as far as pos- sible through the alxiominal walls. Care must, of course, be taken to avoid injuring the abdominal viscera. The puncture may be simply ex- ploratory, it may be followed by irrigation of the cavity with a three- per-cent. solution of cart)olic acid, or it may be followed by an injection of iodine into the sac. A cannula should not be left in the sac to ex- cite suppuration. If the tumor is not perfectly accessible through the vaginal vault, it should not be punctured. The operation should not be performed through the abdominal wall. Incision may be practiced through the vagina'for certain cases of hydrosalpinx if puncture does not suffice. 8. Puncture Buy Tacrolimus has been performed in many instances by the author, and never with bad results. Errors of diagnosis, before puncture, were revealed when the operation was performed in cases of ovarian, echi- nococcal, and parovarian cysts, and in tubal pregnancies. 9. In cases of pyosaipinx it may be remembered that a spontaneous cure sometimes takes place, that radical treatment is not always de- manded, and that the course of mai;y cases is without prominent symp- toms. 10. Mechanical treatment is not suitable for pyosaipinx, neither is puncture, in so Buy Tacrolimus Online far as the latter is intended as a curative measure. 11. Incision and excision alone are indicated, the former for single, the latter for multiple pus sacs. 12. Incision may be made through the vagina, the abdotninal wall, or both, according to the conditions. 13. Incision may be luade through the vaginal vault without the aid of a speculum or dragging forward of the uterus. 14. If the pyosaipinx is adherent at the vaginal vault, the perito- niBum need not be opened. If there is a tumor in each side of the pelvis, an abdominal operation is to be preferred. I."). Should there be much liaMuorrhage, it may usually be checked with torsion forceps. 16. .\ T drainage-tube should be left in the sac for eight or ten days, and iodoform gauze may be p.icked arovmd it for twenty-four hours should the lucmorrhage be obstinate. Vaginal douches should be given daily, and the patient will usually be able to sit up in eight Generic Tacrolimus days. 17. The incision will usually heal readily. If there is retention of the sac contents, the wound should be dilated with the finger. 18. The immediate and remote results of this operation are, as a Order Tacrolimus Online rule, very satisfactory. 19. If the pus sacs are near the abdominal wall, the incision is made through the latter, and if the sacs are not adherent, they are evacuated and stitched to the abdominal wall. 20. The proper site forthe aliilominal incision will depend upon the position and size of the sac and its relation to the intestine. 21. A counter-opening through the vagina for drainage will only be required in Purchase Tacrolimus Online case of large tumors. 22. In exceptional co-ses in which attachments to intestines prevent one from bringing the tumor forward an
|