Pyosalpinx 445 



possible escape of the infection into the peritoneal cavity. 

 Consequently it is best to secure the cornu carefully upon 

 either side of the point of the intended amputation and take 

 ample precautions against escape of any infection into the 

 peritoneal cavity. The stump of the cornu should be closed 

 as in the operation for appendicitis in man. That is, the 

 mucosa should be sutured or ligated and pushed back into 

 the lumen of the horn, and then the serosa and musculosa 

 drawn together over the mucosa with durable gut sutures. 

 The operation of spaying has been described in Chapter XI. 



2. Pyosalpinx 



In the simple salpingitis which is described in the pre- 

 ceding paragraph, no appreciable amount of pus is formed. 

 Sometimes, however, there is a considerable volume of pus 

 formed in the oviduct, which definitely distends it, rendering 

 it palpable. In some cases the duct is moderately enlarged 

 and the walls very thick, hard, and readily palpable per rec- 

 tum. In other cases which I have encountered, there is a 

 considerable distension of the oviduct, its walls become thin 

 and paretic, and the tube becomes soft and fluctuant. In 

 such cases, as a rule, at least in the specimens in my collec- 

 tion, the pavilion of the tube is adherent about the ovary or 

 to the mesosalpinx or mesometrium and the pus surrounds 

 the ovary more or less completely, and causes its partial or 

 total necrosis. 



In a third group, which is illustrated in Figures 157, 158, 

 a large tubo-ovarian abscess forms, sometimes containing 

 eight to ten or fifteen ounces of thick pus. In these cases, 

 neither ovary nor tube is recognizable, but in their stead is 

 a great sclerotic abscess with very heavy, thick walls. In 

 many cases the abscess does not become firmly adherent to 

 other organs and does not point and break. In some of my 

 specimens, where adhesions are very extensive, it seems 

 probable that in the complex abscessation there have been 

 tubo-ovarian abscesses which have emptied into the neigh- 

 boring organs, but the destruction has been so great that 

 the question can not be clearly determined. 



