Ectropion

ECTROPION (from Greek ectrepo- I turn inside out), eversion, such an incorrect position of an organ or its part when its inner surface assumes the position of the outer surface. Thus, E. of the eyelid is the separation of the lower edge of the eyelid from the eyeball with subsequent drooping of the eyelid and the turning of the conjunctiva outward. E. of the uterus (the Latin term inversio is more commonly used) is the prolapse of one part of the uterus into another: of its fundus into the cervix and further into the vagina, whereby the mucous membrane forms a convexity, while the outer surface, covered with peritoneum, forms a depression, or the so-called "funnel of eversion." To this should also be attributed the eversion of the mucous membrane of the cervical canal of the uterus and the eversion of the mucous membrane of the bladder directed into the vagina in postpartum vesicovaginal fistulas. The causes of E. can be varied. Thus, E. of the eyelid can be of muscular origin and is either paralytic or spastic. The most frequent cause is inflammatory processes ending in scarring and contraction of the skin, i.e., scar E. In the uterus, E. is caused by strong traction downward, the point of application of which is the inner surface of the organ. Puerperal E. arises from the pulling of the mucous membrane from the side of the placenta that has not yet separated; in other cases it is caused by traction from the side of intrauterine tumors. The mechanism of formation of E. is the same in both cases. E. of the mucous membrane of the cervical canal can occur with edema of the cervix, after deep tears with subsequent scarring. A necessary prerequisite for E. is the relaxation of the wall of the organ (e.g., the flaccidity of the uterine wall in its prolapse).