Case of aneurism of the aorta arising from the back part of the arch, simulating laryngeal disease, and fatal by suffocation / by W.T. Gairdner.

  • Gairdner, W. T. (William Tennant), Sir, 1824-1907.
Date:
[1851]
Catalogue details

Licence: Public Domain Mark

Credit: Case of aneurism of the aorta arising from the back part of the arch, simulating laryngeal disease, and fatal by suffocation / by W.T. Gairdner. Source: Wellcome Collection.

    3/12 (page 3)
    a The heart weighed 12^ oz.; its muscular tissue much congested. On the aortic valves, which were quite competent, and not at all deformed, there were one or two very minute granulations, and a few similar ones on the inner membrane of the vessel near its origin. The other valves perfectly normal. The thoracic aorta had its inner membrane throughout uneven and thickened, but with little distinct abnormal deposit. The arch presented no general dilatation; it was, however, slightly dilat ed upwards at the root of the innominata; and this vessel, as well as the origin of the right subclavian, was uniformly large relatively to the vessels on the opposite side. The two carotids were of equal size; but both of them, as well as the left subclavian, were very slightly expanded at their origin. At the back part of the arch, half an inch below and between the origin of the innominata and left carotid, was an oval opening, through which a hazel nut might be passed lengthways. Its edges were tolerably smooth and rounded; and it was three-quarters occluded by a mass of firm granular coagulum, which passed from this opening into the aneurismal sac beyond. This was of the size of a walnut, and was situated between the aorta and the trachea, being adherent to the perichondrium of some of the tracheal rings; the sac was nearly full of laminated, decolorized coagula, with a little fluid blood. The left recurrent nerve, emerging from below the aorta, passed immediately to the left of the sac, and rather behind it, being bent over it, and at one point almost imbedded in the thickened cellular tissue which surrounded it; at this point there were also one or two indurated lymphatic glands around the nerve, dark from carbonaceous deposit. -The pneumogastric nerve on both sides, and the recurrent on the right, had their normal relations, excepting that the subclavian artery, where it was surrounded by the right recurrent, was, as before mentioned, somewhat dilated. The tongue rather brown, and dry in front. Its root, and the fauces natural. The epiglottis normal in size and form; its mucous membrane faintly rose-coloured on the posterior aspect, and displaying a some¬ what granular surface, from prominence of the mucous follicles, especially in the neighbourhood of the arytsenoid cartilages. Ven¬ tricles of larynx and vocal cords natural. The cricoid cartilage and three upper tracheal rings divided by a perpendicular incision in the middle line. The mucous membrane in the larynx and upper fourth of the trachea nearly natural in colour and appearance. Below this the mucous membrane presented rose-coloured vascularity, deepening towards the bifurcation, on the left side, into purple. The mu¬ cous membrane slightly granular throughout this injected part from hypertrophy of the follicles. About an inch and a quarter above the bifurcation on the left side there was a circular opening, admitting readily a crow-quill, and