A practical guide for making post-mortem examinations : $b and for the study of morbid anatomy, with directions for embalming the dead, and for the preservation of specimens of morbid anatomyThomas, A. R. (Amos Russell)
Science
A practical guide for making post-mortem examinations : $b and for the study of morbid anatomy, with directions for embalming the dead, and for the preservation of specimens of morbid anatomy
Thomas, A. R. (Amos Russell)
Anatomy, Pathological; Autopsy -- Handbooks, manuals, etc.
=Hydrocele.= _Simple Hydrocele_ is a dropsy of the tunica vaginalis. The
fluid is usually clear, and of a straw color, sometimes turbid, with
albuminous flocculi, and not unfrequently contains shining particles of
cholesterine. In old or very large hydrocele, it is often dark-brown or
chocolate colored from disintegrated blood. Its quantity is sometimes
very considerable. The position of the testicle may be altered by
adhesions formed between the two layers of the tunica vaginalis; these
latter may also produce a multilocular hydrocele. Simple hydrocele may
occur with some of the other varieties to be mentioned, and also with
inguinal hernia.
When serous effusion in the tunica vaginalis, is associated with chronic
orchitis or other diseases of the gland, we have _hydro-sarcocele_.
In _congenital hydrocele_, the dropsical tunica vaginalis retains its
fœtal communication with the peritoneal cavity.
_Encysted Hydrocele._ In this variety the fluid is contained in cysts,
which may be situated (1) beneath the visceral portion of the tunica
vaginalis, investing the epididymis; (2) between the testicular portion
of the tunica vaginalis and the tunica albuginea, which are thus
separated from each other; (3) between the layers of the loose or
reflected portion of the tunica vaginalis. The two last mentioned
varieties are of rare occurrence. The cysts have thin fibrous walls, a
lining of tessellated epithelium, and contents usually clear, although
sometimes mixed with various exudations of fibrin or even blood.
Spermatozoa are very frequently found in the fluid of these cysts. Their
presence is undoubtedly due, as pointed out by Cushing, to the rupture
of a neighboring seminal duct. They are but rarely found in the fluid of
common hydrocele.
_Diffused Hydrocele of the Cord_, gives rise to an oval or oblong,
irregular, circumscribed tumor, extending below and into the inguinal
canal. “It consists in the enlargement of the cells of the areolar
tissue, and their distension with a white or yellowish serous fluid. The
inclosing fascial sheath is condensed and thickened, and at the lower
part of the swelling, which is always the largest, separates it
completely from the tunica vaginalis.”
_Encysted Hydrocele of the Cord_ forms a tumor of oval shape, loosely
attached to the vessels of the cord which pass behind it. Instead of a
single cyst, there may be a number, forming a series along the cord.
=Hæmatocele=, is a tumor formed by an effusion of blood from the vessels
of the testis or of the spermatic cord, into the cavity of the tunica
vaginalis. It may be traumatic or spontaneous, and may attain a large
size. Coagula are formed either in separate masses, or in firm layers,
as in aneurism. Inflammation may be set up, leading to fibrinous and
serous effusion, and to suppuration, or the blood may putrify and
gangrene result. The tunica vaginalis is commonly thickened, the
testicle unaffected, or in old cases atrophied from pressure.
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