A case of pulsating tumour of the left orbit, consequent upon a fracture of the base of the skull cured by ligature of the left common carotid artery subsequently to injection of perchloride of iron after digital compression and other means of treatment had failed : with remarks and an appendix containing a chronological résumé of recorded cases of intra-orbital aneurism / by Walter Rivington.

  • Rivington, Walter, 1835-1897.
Date:
1875
Catalogue details

Licence: Public Domain Mark

Credit: A case of pulsating tumour of the left orbit, consequent upon a fracture of the base of the skull cured by ligature of the left common carotid artery subsequently to injection of perchloride of iron after digital compression and other means of treatment had failed : with remarks and an appendix containing a chronological résumé of recorded cases of intra-orbital aneurism / by Walter Rivington. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    Owing to previous compressive treatment the fascia was found condensed and tough, and the tissues were so vascular that one or two superficial vessels had to be secured. The operation, performed as deliberately as possible, was unat- tended with any further difficulty than that resulting from the shape of the neck, and from the muscular development which was considerable, and rendered the vessel rather less accessible than usual. The jugular vein had a tendency to bulge over the artery inside the sheath, but being repressed with the finger gave no trouble. The sheath, being opened suffi- ciently to allow the passage of the aneurism needle, was gently separated from the artery on either side with a director, and the needle and ligature were passed. On tightening the ligature, pulsation at once ceased in the upper eyelid and the tissues became fiiaccid. The bruit ceased for a minute, but was speedily reproduced, though much less loudly than before. No cerebral disturbance or other ill effects followed the operation. The ligature fell on the 5th of August, exactly three weeks afterwards. The swelling of the ocular tissues at once began to subside, and the arrest of pulsation was so complete that not the slightest beat or thrill could be felt in any part of them, and neither the frontal nor supra-orbital vessels could be detected. In a few days I was greatly disappointed at finding that, not- withstanding the steady removal of infiltration of the ocular tissues, a white spot which had appeared at the lower margin of the cornea had enlarged, and that loss of some portion of it was inevitable. A small ulcer formed, and some sloughing of the superficial layers occurred, whilst the rest of the cornea became hazy. As the upper eyelid was relieved it was ascertained that the ophthalmic vein con- tained firm clot, a hard rounded body occupying the place of the soft rounded pulsating swelling which had previously existed there. The patient went out in the middle of Sep- tember. At that time I was away from the hospital, but he came to see me a month later. The eye had quite regained its position in the orbit, and the upper lid had to some extent recovered its power of movement. A narrow fold of