The pathology and surgical treatment of tumors . to bemistaken for spina bifida if the opening in the spinal canal is smalland the integument covering it is normal. The difficulty in diagnosisis increased if, as sometimes happens, the spina bifida is associated witha dermoid. Wild reported the case of a man twenty-two years oldwho was born with what was supposed to be a spina bifida in thelumbo-sacral region (Fig. 453). The swelling never caused any painor inconvenience until it became inflamed, when it suppurated andopened .spontaneously, discharging a large quantity of offensive pus,hair, an
The pathology and surgical treatment of tumors . to bemistaken for spina bifida if the opening in the spinal canal is smalland the integument covering it is normal. The difficulty in diagnosisis increased if, as sometimes happens, the spina bifida is associated witha dermoid. Wild reported the case of a man twenty-two years oldwho was born with what was supposed to be a spina bifida in thelumbo-sacral region (Fig. 453). The swelling never caused any painor inconvenience until it became inflamed, when it suppurated andopened .spontaneously, discharging a large quantity of offensive pus,hair, and sebaceous material. The was freely Its wallshowed numerous openings of sweat-glands, from which drops ofsweat escaped when the patient perspired. TERA TO MA. 633 At the junction of the sacrum with the coccyx, and over the coccyxat a point corresponding with the post-anal dimple, dermoid cysts arequite frequently found. They are usually small, and they are oftenassociated with a blind fistulous tract. In a number of cases where. Fig. 453.—Dermoid in the lumbo-sacral region of a man twenty-two years of age (after Sutton). cysts in this locality had suppurated a small fistulous opening remained,and when this opening became closed the swelling reappeared andagain suppurated. In the removal of suppurating dermoids in the sacro-coccygealregion the careful use of the probe is necessary to ascertain the extentand exact location of the cyst. The writer has usually found more orless hair as a part of the cyst-contents. The displacement of skintakes place here so frequently because of the early adhesion of theskin to the underlying bone, and the subsequent growth of the sur-rounding fat and muscle-tissue, causing the dimpling, sinus-formation,or epithelial inclusions as the case may be. No operation for a supposed dermoid anywhere over the spineshould be undertaken until spina bifida has positively been excludedby an exploratory puncture, which can be repeated if neces
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectneoplas, bookyear1895
