Tuberculosis of the tunica vaginalis testis, with a clinical and pathological report of two cases : from the Surgical Out-Patient Department of the Royal Hospital for Sick Children / by Harold J. Stiles.

  • Stiles, Harold J. (Harold Jalland), 1863-1946.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Tuberculosis of the tunica vaginalis testis, with a clinical and pathological report of two cases : from the Surgical Out-Patient Department of the Royal Hospital for Sick Children / by Harold J. Stiles. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    A fourth case, operated on by Niehans, is mentioned in Kocher’s ^ work, where it is stated that there was a serous communicating hydrocele associated with tubercular peritonitis, Mr. Alexis Thomson mentions, in the first volume of these Reports, a fifth case, in which the sac liad become converted into a tubercular abscess. The condition resembled somewhat an mflamed hernia. At the operation it was fomid impossible to separate the sac from the testicle, so that the latter, although healthy, had to be excised. The cord was infiltrated with caseous tubercle. The child was 2 months old, and had a “ large abdomen.” In discussing the pathogenesis of this group, M. Phocas ^ leans to the view that the abdominal tuberculosis is secondary to the disease in the processus vaginalis. I am inclined, however, to favour the converse hypothesis, namely, that the hydrocele is secondary to, or, more correctly perhaps, part of an abdominal tubercular peritonitis. That the hydrocele may be the first, and even the only condition which attracts attention, is not surprising, 'when we remember how slow and msidious may be the progress, and how ill-marked the symptoms of peritoneal tuberculosis. It is well known, also, that the disease may remain quiescent, or even undergo spontaneous heahng. Post-mortem examinations not infre- quently reveal the remains of an abdominal tuberculosis, the existence of which, during life, was not even suspected. While it is beyond the scope of this paper to include the subject of tubercular hernise, a short reference to it is advan- tageous, as helping to throw some light upon the pathogenesis of tubercular communicating hydrocele. I have been able to discover only 2 0 recorded cases of tubercular hernia?. Bruns ® has described an interesting case, and gives an admirable epitome of 12 others, all collated from French literature. More recently Southam,^ Kemedi,® and Bernard Pitts ® have 1 Deutsche Chir, Lief. 506, s. 151. - Loc. cit. * BeitrUge z. klin. Chir. Bd. -\i. s. 209. Medical Chronicle, vol. xvi. p. 19. ® Centralbl.f. Chir. 1892, No. 15, s. 319. 8 Trans. Path. Soc. London, vol. xlii. p. 77.