Interstate medical journal . Fig. 1.— Brauehiogenetic Cyst. COMPLETE MEDIAN CERVICAL FISTULA. 355 of the neck, and while it is necessary to make a differential diagnosis be-tween them and aneurisms, hcemato-cysts, lymphangioma, cystic goitreand lymph-angiectetic cysts; it is the latter only that will present a realdifficulty. In the latter the finding of endothelium instead of epitheliumwill decide. Case.—Patient, age 38, merchant, of small stature, slight build, notrobust but otherwise healthy, presented a prominent and large swellingon the right side of the neck, occupying completely the rig
Interstate medical journal . Fig. 1.— Brauehiogenetic Cyst. COMPLETE MEDIAN CERVICAL FISTULA. 355 of the neck, and while it is necessary to make a differential diagnosis be-tween them and aneurisms, hcemato-cysts, lymphangioma, cystic goitreand lymph-angiectetic cysts; it is the latter only that will present a realdifficulty. In the latter the finding of endothelium instead of epitheliumwill decide. Case.—Patient, age 38, merchant, of small stature, slight build, notrobust but otherwise healthy, presented a prominent and large swellingon the right side of the neck, occupying completely the right anteriortriangle, extending from the lower jaw to beyond the sterno-claviculararticulation and from the sterno-cleido-mastoid to near the median line ofthe neck. The swelling was tensely elastic, fluctuating, slightly movablelaterally; communicated carotid pulsation marked. Skin movable over. oprwve of rt/rfe CitSS^L Fig. 2.—Complete Thyroglossal Fistula. tumor, normal except at lowest point where it was red and tender on pres-sure. Swelling had first been observed fifteen years previously oppositethe thyroid cartilage, had been growing more rapidly of late, and becom-ing tense and then painful; patient observed that pressure would giverelief; he applied it frequently and finally noticed that on firm pressurefluid would get into the mouth and he thought the fluid was pus. Exami-nation revealed a small opening at the lowest point of the palato-pharyngeal arch through which on pressure, a pus-like fluid accompanying photograph will fairly show the size and position ofthe tumor. Diagnosis,—branchio-genetic cyst or. more correctly, cysticfistula. For the relief of the condition several methods had to be con-sidered; puncture and emptying of the sac, followed by iodiu or carbolic 356 TUHOLSKE. acid injections, incision and drainage and extirpation. Decided onexti
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectmedicine, bookyear190
