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Diagnostic curettage
needed in 58 eases; in 55 tffo laminalia wele used, and in four eases thee wel-e employed, Fifteen per cent of the ease- - 0ere in0orrcotly diagnosed by the usuhl methods but with the digital examination the following diagnoses were made: malignant n(3iTvgrowth, 2 cases!; submucous fibroids, 7; uterine polyps, 6; pregna.ncy, Digital examina.tion of 22 incomplete abortion and missed abortion, each 1 case. cases of suspected fibroids revealed that 3 were malignant newgrowths, 5 were uterine polyps, and two were really fibroids. Following this type of examination a moderate rise of temperature was observed in ten per cent of the easeB only, and I-arely was it necessary to use opium to allay pain. A. C. WILLI~MSSOW. EIesse, W.: in Gases lxx, 51.
The Diagnostic Value of Anomalous Bleeding.
of Digital Xiinchencr
Exploration Xedizinisehe
of the Uterine Wochenschrif,
Cavity 1923,
In this series of 400 patients the dilatation technic of Walthard was used. The cervix is dilat,ed by use of the Hegar dilator plus the laminaria, one, two or three being used as it is considered advisable. In cases where the tents alone were used the+re was a febrile reaction in but 7 per cent o f the casesT while in those where the metal dilators were used the incidence mounted to 42 per cent. As soon as fever :s noted the laminaria are removed nntil temperature has returned again to normal. Uteri which are apparently empty aye cur&ted ca,refully for microscopic examination. Changes in the mucous membran,e and the uterine walls are easily detected and if anything escapes the finger careful curettage afterward will usually prevent a slip. Digital exploration is employed not only in eases of anomalous bleeding with a changed utcros, but also in eases where the uterus and its appendages seem to be normal. A. C. WXLLIAMSON. Dtiessen 1923,
: Diagnostic xi, 677.
Curettage.
NcderIandsch
Maandsohrift
voor
Geneeskunde,
Driessen calls attention to the fact that, while a minor operative procedure, curettage is not without danger and should therefore not be undertaken unde’r lnzfavorable surroundings. He feels that when doing a curetta,ge lone should always be prepared to do an hysterectomy. To tns ~usnal dangers of curettage, namely perforation, septic infection, exacerbation of an existing inflammatoq process and He cites a case of his obliteration of the uterine cavity, he adds hcmorrhage8. own and one of a colleague in which mere dilatation caused b1eedin.g of s~uch severity that a prompt hysterectomy had to bme performed in order to save the patient’s lifr. In both cases the bleeding was caused b,v a malignant c.lioriontipitheliolIla. Since both of these cases had been curettecd previously, they accentuate the necessity of examining all curettings. Driessen feels that while menorrhagia is not ordinarily an indication fog curettage, metrorrhagia is practically always, even when the diagnosis seems proved clinically. He applies this rule to fibroids which are to be subjected to radiation. He is inclined to curette for a!1 bleeding near the menopause and calls attention to the care required in making a diagnosis, as the premenstrual endometrium has been mistaken for malignant adenoma. He believes that oorpus carcinoma is more common than usuaily supposed. In eighty-five women over fotiy which he euretted previous to radiation, he encountered carcinoma thirteen times. He employs either ethyl chloride or ether as an an&betic. R. E. W-ORUS.
The Diagnostic Value of Anomalous Bleeding.
of Digital Xiinchencr
Exploration Xedizinisehe
of the Uterine Wochenschrif,
Cavity 1923,
In this series of 400 patients the dilatation technic of Walthard was used. The cervix is dilat,ed by use of the Hegar dilator plus the laminaria, one, two or three being used as it is considered advisable. In cases where the tents alone were used the+re was a febrile reaction in but 7 per cent o f the casesT while in those where the metal dilators were used the incidence mounted to 42 per cent. As soon as fever :s noted the laminaria are removed nntil temperature has returned again to normal. Uteri which are apparently empty aye cur&ted ca,refully for microscopic examination. Changes in the mucous membran,e and the uterine walls are easily detected and if anything escapes the finger careful curettage afterward will usually prevent a slip. Digital exploration is employed not only in eases of anomalous bleeding with a changed utcros, but also in eases where the uterus and its appendages seem to be normal. A. C. WXLLIAMSON. Dtiessen 1923,
: Diagnostic xi, 677.
Curettage.
NcderIandsch
Maandsohrift
voor
Geneeskunde,
Driessen calls attention to the fact that, while a minor operative procedure, curettage is not without danger and should therefore not be undertaken unde’r lnzfavorable surroundings. He feels that when doing a curetta,ge lone should always be prepared to do an hysterectomy. To tns ~usnal dangers of curettage, namely perforation, septic infection, exacerbation of an existing inflammatoq process and He cites a case of his obliteration of the uterine cavity, he adds hcmorrhage8. own and one of a colleague in which mere dilatation caused b1eedin.g of s~uch severity that a prompt hysterectomy had to bme performed in order to save the patient’s lifr. In both cases the bleeding was caused b,v a malignant c.lioriontipitheliolIla. Since both of these cases had been curettecd previously, they accentuate the necessity of examining all curettings. Driessen feels that while menorrhagia is not ordinarily an indication fog curettage, metrorrhagia is practically always, even when the diagnosis seems proved clinically. He applies this rule to fibroids which are to be subjected to radiation. He is inclined to curette for a!1 bleeding near the menopause and calls attention to the care required in making a diagnosis, as the premenstrual endometrium has been mistaken for malignant adenoma. He believes that oorpus carcinoma is more common than usuaily supposed. In eighty-five women over fotiy which he euretted previous to radiation, he encountered carcinoma thirteen times. He employs either ethyl chloride or ether as an an&betic. R. E. W-ORUS.