Sclerotic Metritis 



605 



E. Sclerotic Metritis. 

 Sclerosis of the uterine walls generally accompanies long- 

 continued metritis, but as a rule the sclerosis is not very 

 marked. There may be distinguished upon rectal palpation 

 a definite thickening and hardening of the walls, which does 

 not constitute an important factor in the prognosis and 

 handling of the disease. If the uterine mucosa is restored 

 to health, the sclerosis abates and disappears. There is, 

 however, an extreme type of sclerosis which is not rare and 



Fig. 189 — Sclerotic Metritis with Pyometra. 



/, Cervical canal ; 2, sclerotic annular folds of cervix pushing canal far 



downward ; j, cavity of uterus and horn containing pus. 



Uterine mucosa destroyed. 



which it is important to recognize clinically. This type I 

 have designated as sclerotic metritis. It is characterized 

 by greatly thickened walls, one-half to one inch in diameter, 

 very dense and hard. A typical example is shown in Fig. 

 189. The disease is evidently the result of long-continued 

 intra-uterine irritation. It may be due to fetal retention, 

 as shown in Fig. 171. In the definitely post-puerperal cases 

 I have not been able to trace the disease to its fundamental 

 cause as all my examples are from the abattoir and hence 

 without clinical history. It appears fairly safe to attribute 

 the condition ordinarily to neglected or maltreated retained 



