The first thought of every surgeon who, on opening the abdomen of a woman, finds it full of blood, is that a ruptured extra-uterine gestation has been the source of the bleeding. In the great majority of cases, this surmise proves to be correct. Although the condition of "hematocele retro-uterina" had been described by Nélaton as far back as 1850, it was not until 1873 that Gallard emphasized the importance of ectopic gestation in the causation of such hemorrhages. Previous to that time, pelvic hematocele had been explained as due to such causes as rupture of varicose veins in the broad ligament, reflux of menstrual blood through the fimbriated extremities of the tubes, coitus during menstruation, etc.
At the present time gynecologists are still, and quite properly, inclined to look on the existence of free bleeding in the pelvis, whether or not it extends into the abdominal cavity proper, as
NOVAK E. ABDOMINAL HEMORRHAGE OF OVARIAN ORIGIN: WITH REPORT OF A CASE DUE TO RUPTURE OF A SMALL FOLLICULAR CYST. JAMA. 1917;LXVIII(16):1160–1162. doi:10.1001/jama.1917.04270040148002
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