702 THE REPRODUCTIVE ORGANS OF THE FEMALE. 



infection. Under these conditions the wall of the tube may be involved 

 and pus may exude from the abdominal ends. It is difficult, in many 

 cases of suppurative salpingitis associated with peritonitis, to say which 

 is the primary lesion. 



If the abdominal end of the tube be closed by adhesions or otherwise 

 there may be a considerable collection of pus in the tubes, causing dila- 

 tation pyosalpinx (Figs. 458 and 459). Such a collection may rupture 

 into the peritoneal cavity, or the pus may escape into a cavity shut in by 



FIG. 459. PYOSALPINX. 

 Showing a cysWike distention of the occluded tube. 



adhesions, or may perforate into the intestine or bladder. Or it may 

 dry and finally become calcified. 



Suppurative salpingitis is most commonly incited by the gonococcus 

 or the pyogeuic bacteria. 



Tuberculous Salpingitis. The lesions are most frequently seen in the 

 later stages of the process, when the mucous membrane is partially or 

 entirely converted into a thick, caseous, often ulcerating layer (Fig. 400). 

 The lumen of the tubes may be dilated, and the walls thickened from 

 chronic inflammation. This lesion may occur by itself, or may be asso- 

 ciated with tuberculous inflammation of the lungs, or of the other genito- 

 urinary organs, or of the peritoneum. It usually commences at the 

 abdominal ends of the tubes, and both tubes are apt to be involved. 



Syphilitic Inflammation, manifested by a diffuse fibrous thickening of 

 the wall, has been described. 



TUMORS. 



Small fibromata and fibro-myomata sometimes occur in the wall of the 

 tubes or in the fimbria?. Small lipomata have been seen between the folds 



