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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    each reported 2 cases, and Haegler^ 1 case. Taking the 20 cases, I find that the sac was tubercular in 17, in 11 of which it was the only part of the hernia involved. The presence of general abdominal tuberculosis was demonstrated in 12 of the cases; of the remaining 8, the tubercle was confined to the hernia in 1 (Cruveilhier’s);^ in 3 (Haegler, 1 ; Bernard Pitts, 2) this was believed to be the case; and in 4 no mention is made of the abdominal condition. The above statistics show that the greater majority of cases of tubercular hernia are aecompanied by general peritoneal tuberculosis. Lejars ® and Jonnesco * agree that the hernia is the primary seat of the disease, and Southam ® believed that this was so in both his cases. That such may be the order of events, in exceptional eases, must be admitted; I agree, however, with Bruns,® that tubercle of a hernia is, as a rule, only a part of the con- dition of general abdominal tuberculosis, and not the cause of it. The rarity of tubercular hernise even in tubercular subjects, shows, as pointed out by Bruns, that they have no special tendency to become infected. Albert records two cases in which the herniae escaped, although the patients who possessed them suffered from general peritoneal tuber- culosis. The form which the tubercle presents when affecting hernias varies. The tubercles are generally small and scattered, and attended with a serous effusion; but they may be confluent, and form large cheesy nodules, projeetmg from the sac, or matting together the omentum. More rarely the sac is filled with tubercular pus. The pathogenesis and morbid anatomy, therefore, of tubercular communicating hydrocele is the same. Let me now pass to my own cases, the special feature of which is, that the tunica vaginalis and funicular process, instead of containing fluid, and thereby constituting a hydro- cele, were distended with solid tubercular tissue. 1 Correspond.-Bl. f. schweiz. Aerzte, Jahrg. xxii. 1892. 2 Train d’anat. path, ghiir. Tome iv. p. 669. “ Gazette des lldpitaux, No. 88, p. 801. * Revue de chir. Tome xi. p. 185. Loc. cit. ® Loc. cit.
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