Anatomy, Surgical and topographical -- Atlases; Surgery -- Atlases; Surgery, Operative -- Atlases
PLATE 40, Fig. 3.--Hydrocele of the isolated tunica vaginalis.--When the
serous spermatic tube, 6 b, 6 c, becomes obliterated, according to the
normal rule, after the descent of the testicle, 7, the tunica vaginalis,
6 d, is then a distinct serous sac. If a hydrocele form in this sac, it
may be distinguished from the congenital variety by its remaining
undiminished in bulk when the subject assumes the horizontal position,
or when pressure is made on the tumour, for its contents cannot now be
forced into the abdomen. The testicle, 7, holds the same position in
this as it does in the congenital hydrocele. [Footnote] The radical cure
may be performed here without endangering the peritonaeal sac.
Congenital hydrocele is of a cylindrical shape; and this is mentioned as
distinguishing it from isolated hydrocele of the tunica vaginalis, which
is pyriform; but this mark will fail when the cord is at the same time
distended, as it may be, in the latter form of the complaint.
[Footnote: When a hydrocele is interposed between the eye and a strong
light, the testis appears as an opaque body at the back of the tunica
vaginalis. But this position of the organ is, from several causes,
liable to vary. The testis may have become morbidly adherent to the
front wall of the serous sac, in which case the hydrocele will distend
the sac laterally. Or the testis may be so transposed in the scrotum,
that, whilst the gland occupies its front part, the distended tunica
vaginalis is turned behind. The tunica vaginalis, like the serous
spermatic tube, may, in consequence of inflammatory fibrinous effusion,
become sacculated-multilocular, in which case, if a hydrocele form, the
position of the testis will vary accordingly.--See Sir Astley Cooper's
work, ("Anatomy and Diseases of the Testis;") Morton's "Surgical
Anatomy;" Mr. Curling's "Treatise on Diseases of the Testis;" and also
his article "Testicle," in the Cyclopaedia of Anatomy and Physiology.]
[Illustration: Abdomen and scrotum, showing bone, blood vessels
and other internal organs.]
Plate 40--Figure 3.
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