Papilloma of the Fallopian tube and the relation of hydroperitoneum to tubal disease / by Alban Doran.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927.
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Papilloma of the Fallopian tube and the relation of hydroperitoneum to tubal disease / by Alban Doran. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    10/12 (page 8)
    tion of tlie ovaries existed.* Dr. Bantock removed the ovaries ; tlie peritoneal effusion did not recur. Lastly, I must return to the proposition already dis- cussed when considering that papilloma of the tube may represent a form or result of inflammation of the tube. The first case proves that papillomatous salpingitis, as the disease should be termed under this theory, causes hydro- peritoneum if the ostium be not obstructed. Let the papillomatous complication be subtracted, and only chronic catarrh remain, may not hydroperitoneum still develop itself ? This brings me back to another proposition already made in this paper, namely, the theory that catarrhal fluid escaping from the tube may irritate the peritoneum and cause effusion. If this last theory be correct, as I firmly believe, why is not hydroperitoneum from tubal disease more common ? This question brings us once more round to another sub- ject already discussed. Salpingitis almost always causes closure of the'ostium of the tube, so that the peritoneum is protected. In other cases the disease sets up local peritonitis, causing adhesions of the ovary, broad ligament, tube, and other structures. These adhesions very soon close the tube by bands which press on its outer surface, or by effusions which mat its fimbriae together. In this manner the general peritoneal cavity is saved from irrita- tion. All this local peritoneal mischief appears to me to represent an acute form of salpingitic complication, of which hydroperitoneum is a mild form. In fact, salpin- gitis cannot set up hydroperitoneum except it be so mild and so purely catarrhal as neither to cause closure of the ostium nor to inflame acutely the pelvic peritoneum. Hence the salpingitis of childbirth, abortion, and gonor- rhoea can seldom, if ever, cause simple hydroperitoneum, though it is a fertile source of hydrosalpinx, pyosalpinx, and pelvic peritonitis. This closure of the ostium is a most fortunate complication in so far as it protects the * “ Hydroperitoneum traced to Chronic Ovaritis; Oophorectomy; Reco- very,” ‘ British Medical Journal,’ vol. ii, 1881, p. 699.