4^6 Diseases of the Genital Organs 



and more or less swelling of the parts. There is usually a 

 profuse exudate in the lumen. The mucosa may be thick- 

 ened by a small-celled infiltration and the epithelium show 

 cloudy swelling, fatty degeneration, desquamation, or, as is 

 often the case, total destruction. Owing to cellular infiltra- 

 tion and the formation of granulation tissue, the folds may 

 become thickened and often fuse, with the production of 

 cyst-like cavities lined by epithelium. In some cases the 

 greatly increased blood vessels show hyaline or amyloid in- 

 filtration of their walls, as shown in Fig. 151. The muscular 

 coat often shows hypertrophy and small-celled infiltration, 

 either diffusely or in collected areas. 



The exudate into the lumen is probably discharged into 

 the uterus, where it may cause metritis or cervicitis. If the 

 secretion is unable to escape readily in that direction, either 

 through swelling of the parts or atresia of the uterine osti- 

 um, it is discharged on the fimbria or ovary, with subse- 

 quent inflammation of the parts. Here it may produce a 

 simple serous inflammation, though more often it assumes a 

 fibrinous character, with the resulting formation of adhe- 

 sions, fibrinous strands between the fimbriae and ovary, or 

 closure of the ostium abdominale. Not infrequently the en- 

 tire pavilion becomes adherent to the ovary, in which case 

 there may result a tubo-ovarian cyst or abscess. If the dis- 

 ease spreads farther, there may occur a fibrinous peri-sal- 

 pingitis with the formation of numerous fibrous strands 

 running from the tube to the neighboring parts of the broad 

 ligament. With closure of both the ostium abdominale and 

 uterine ostium, the result is very often an accumulation of 

 the contents, with the formation of hydrosalpinx or pyosal- 

 pinx. 



The lesions may vary greatly according to intensity and 

 duration. In the simpler type of the early stages, the mu- 

 cosa is swollen, congested, and the seat of small-celled infil- 

 tration. The lumen may contain fibrinous exudate mingled 

 with desquamated epithelium, as shown in Fig. 150. The 

 desquamation involves loss of cilia. With added severity of 

 the infection, the epithelial layers are destroyed one after 



