Manual of Surgery eBook

This eBook from the Gutenberg Project consists of approximately 697 pages of information about Manual of Surgery.

Manual of Surgery eBook

This eBook from the Gutenberg Project consists of approximately 697 pages of information about Manual of Surgery.

The treatment is to remove the cyst.  When it is impossible to remove the whole of the lining membrane by dissection, the portion that is left should be destroyed with the cautery.

Ovarian Dermoids.—­Dermoids are not uncommon in the ovary (Fig. 59).  They usually take the form of unilocular or multilocular cysts, the wall of which contains skin, mucous membrane, hair follicles, sebaceous, sweat, and mucous glands, nails, teeth, nipples, and mammary glands.  The cavity of the cyst usually contains a pultaceous mixture of shed epithelium, fluid fat, and hair.  If the cyst ruptures, the epithelial elements are diffused over the peritoneum, and may give rise to secondary dermoids.

[Illustration:  FIG. 59.—­Dermoid Cyst of Ovary showing Teeth in its interior.]

The ovarian dermoid appears clinically as an abdominal or pelvic tumour provided with a pedicle; if the pedicle becomes twisted, the tumour undergoes strangulation, an event which is attended with urgent symptoms, not unlike those of strangulated hernia.

The treatment consists in removing the tumour by laparotomy.

#Teratoma.#—­A teratoma is believed to result from partial dichotomy or cleavage of the trunk axis of the embryo, and is found exclusively in connection with the skull and vertebral column.  It may take the form of a monstrosity such as conjoined twins or a parasitic foetus, but more commonly it is met with as an irregularly shaped tumour, usually growing from the sacrum.  On dissection, such a tumour is found to contain a curious mixture of tissues—­bones, skin, and portions of viscera, such as the intestine or liver.  The question of the removal of the tumour requires to be considered in relation to the conditions present in each individual case.

CYSTS[3]

[3] Cysts which form in relation to new-growths have been considered with tumours.

Cysts are rounded sacs, the wall being composed of fibrous tissue lined by epithelium or endothelium; the contents are fluid or semi-solid, and vary in character according to the tissue in which the cyst has originated.

Retention and Exudation Cysts.—­Retention cysts develop when the duct of a secreting gland is partly obstructed; the secretion accumulates, and the gland and its duct become distended into a cyst.  They are met with in the mamma and in the salivary glands.  Sebaceous cysts or wens are described with diseases of the skin. Exudation cysts arise from the distension of cavities which are not provided with excretory ducts, such as those in the thyreoid.

Implantation cysts are caused by the accidental transference of portions of the epidermis into the underlying connective tissue, as may occur in wounds by needles, awls, forks, or thorns.  The implanted epidermis proliferates and forms a small cyst.  They are met with chiefly on the palmar aspect of the fingers, and vary in size from a split pea to a cherry.  The treatment consists in removing them by dissection.

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Manual of Surgery from Project Gutenberg. Public domain.