File:Interstate medical journal (1919) (14783995523).jpg

Identifier: interstatemedica2619unse (find matches)
Title: Interstate medical journal
Year: 1919 (1910s)
Authors:
Subjects: Medicine
Publisher: St. Louis, : Interstate Medical Journal
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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f the cord with undescended testicle,yet in a large number of the cases, if not in the majority of the cases,recorded in which a diagnosis has been made preoperatively, casesof torsion with undescended testicle have been diagnosed as hernia.A tabular statement of such cases picked from the literature isappended. With regard to the evolution of these cases and the treatment,Putzu12 made a number of experimental torsions of the spermaticcord in dogs. He found that a double twist effectively cut off thecirculation from the testicle and that the organ atrophied. In many Thorek: Torsion of Spermatic Cord 197 cases it necrosed and sloughed. Simpler torsion had results varyingaccording to the amount of twist and the length of cord twisted.Atrophy may result, but the phenomena may be transitory. Ofdogs that had suffered a double funicular twist, half had to becastrated. If operated within thirty hours of torsion, the testiclecan generally be saved. In slighter twists the time can be extended.
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Authors case, showing point of torsion of the cord and anatomic relations. Lowerillustration presents the gross appearance of testis and cord. The clinical results observed and the operative findings generallyagree with these results. Spontaneous detorsion may and often doesoccur, and is favored by rest, etc., but, as previously stated, the con-dition, if left untreated, may lead to hemorrhagic and ultimategangrene. Atrophy is the more usual result, gangrene with slough-ing being rare. In Scudders list of cases there were 7 not operated;2 of these atrophied and 3 sloughed; the results in the other cases 198 INTERSTATE MEDICAL JOURNAL unknown. In 9 cases observed by Rigby and Howard they saw nocase of sloughing in 4 unoperated. The treatment of choice, if the case is seen early, appears to beto operate. If the testicle be undescended and in such a conditionthat its preservation may with confidence be expected, it should bedrawn down and fixed in place; if fixation is difficult, or if t

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