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.

  • Harold Stiles
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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    vaginalis without the existence also of tubercle in the epididymis or testis. After a long search for such a con- dition, Simmonds only met with one case, and that at the post-mortem of a man who died of general tuberculosis. The only other reference that I can find to the condition is one by Bulteau, who says that it occurs in the form of small disseminated tubercles, or more rarely as larger nodules, and that it is generally accompanied by hydrocele. The variety occurring secondarily to tubercle of the testis, or epididymis, has been carefully studied by Simmonds. Out of the 12 cases examined by him, 8 showed tuberculosis of the tunica vaginalis. In those cases in which it was absent, the disease in the testicle was less advanced, and in one of these the two serous layers were firmly imited throughout b}' a simple adhesive inflammation. AU the specimens were from adults from 28 to 71 years of age. The form pre- sented by the disease in the tunica vaginahs was that of minute, small, seldom larger nodules, scattered more or less abundantly over both layers. In 6 out of the 8 cases hydrocele was present, the fluid being serous and more or less abundant. In 4 the membrane was covered with a dehcate fibrinous layer. In only one case did the disease present the form of a “ fungous periorchitis.” The third form—namely, that oceurring along with abdominal tuberculosis—was first drawn attention to by M. Phocas, so recently as 1891, at the Congr^s de Chii'urgie. Last year M. Phocas ^ reported 3 cases which had been under his care, and discussed the pathogenesis of this and also of the non-tubercular form of “ congenital ” (communicating) hydrocele. The main facts in his cases are as follows:— Case 1.—iEt. 7 ; father tubercular. In the right tunica vaginalis there was an ounce or so of transparent fluid, which could be pressed into the abdomen with difficidty. Testicle and epididymis normal; cord thickened and a little tender. Abdomen swollen, but not tender; no positive evidence of tubercle. Absorbent lotions and tapping having produced no benefit, a radical operation was performed. The sac was 1 Archiv prov. de chir. I. 2, No. 6, p. 355.