File:Modern surgery, general and operative (1919) (14781174421).jpg

Identifier: modernsurgerygen1919daco (find matches)
Title: Modern surgery, general and operative
Year: 1919 (1910s)
Authors: Da Costa, J. Chalmers (John Chalmers), 1863-1933
Subjects: Surgery, Operative
Publisher: Philadelphia : Saunders
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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esorchium, .and if a normal testicle be normally placed torsionof the cord will hardly occur (Chas. L. Scudder, Annals of Surgery, Aug.,1901). The twisting may be toward the right or toward the left. The symp-toms arise suddenly, and usually during exertion. In some cases a hernia alsoexists. When the rotation occurs, the testicle swells, hemorrhages take placeinto it, and gangrene may develop. If the cord of an undescended or par-tially descended testicle twists, swelling and tenderness are noted in the abdo-men or groin. If the swollen testicle is in the scrotum, the gland feels nodularand the epididymis is found to be anterior instead of posterior, as it is in anormally placed gland. The symptoms are sudden pain, vomiting, moderateshock and a swelling in the groin or a swollen testicle in the scrotum. Theswelling receives no impulse on coughing. The symptoms resemble those ofstrangulated hernia, but are less violent, and the bowels, though often muchconstipated, are not obstructed.
Text Appearing After Image:
Fig. 1022.—Hydrocele. Treatment.—An incision should be made, and if the twisting has been recentand the testicle is not gangrenous, the cord may be untwisted and the testiclefastened to the scrotum by a catgut stitch. If the testicle is gangrenous itshould, of course, be removed. Scudder tells us that in 88 per cent, of casesthe testicle is found to be gangrenous. According to Scudder, there are 32cases on record: 31 were operated upon and i was not, but all recovered; in 3the testicle sloughed and in 2 it atrophied (Annals of Surgery, Aug., 1901). Vaginal hydrocele (chronic hydrocele) (Figs. 1022 and 1024, e) is a collec-tion of fluid in the tunica vaginalis testis. An enlargement of the testis maycause it (secondary hydrocele), but in most instances the cause is unknown andno signs of inflammation exist (primary hydrocele). The fluid is albuminous,but it does not coagulate spontaneously; it is thin, straw colored, and maycontain crystals of cholesterin. The testicle is at the lo

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