Tuberculosis of the peritoneum is an indication for, rather than a contraindication to, the operation. The most extensive cases of peritoneal tuberculosis have been cured by opening and draining the abdomen. If the tubes are rendered inaccessible from the involvement of surrounding structures, the operator must content himself with opening and draining the abdomen.
Adenoma of the Fallopian tube is a rare disease; but a few cases have been described in medical records. The presence of primary adenoma in the Fallopian tube is strong proof of the glandular character of the mucous membrane—an anatomical point which, as has already been said, has been denied by some writers. In adenoma the tube becomes distended with the typical adenomatous mass, which may protrude from the abdominal ostium.
In some of the reported cases there has been found a considerable quantity of free fluid in the peritoneum, though the peritoneum itself was not diseased. It seems probable that this secretion originated in the tube and escaped at the ostium.
Myoma.—Notwithstanding the frequency of myomatous tumors of the uterus, the condition is exceedingly rare in the Fallopian tubes. The tumors originate in the muscular coat, and are usually so small as to create no disturbance.
Cancer.—Primary cancer of the Fallopian tubes is an extremely rare disease. A very few isolated cases have been reported.
Cancer of the tubes secondary to cancer of the body of the uterus occurs more frequently.
Sarcoma of the tube is a very rare disease.
Actinomycosis of the Fallopian tubes has been described.
Syphilitic gummata occasionally attack the Fallopian tube in women who are the victims of constitutional syphilis.
The diagnosis of these unusual lesions of the Fallopian tubes is impossible with our present knowledge. The conditions have usually been found post-mortem or have been unexpectedly discovered at operation. The subjective symptoms throw no light upon the subject of differential diagnosis. Examination reveals merely a tubal tumor.