Observations on aneurism of the abdominal aorta / by Alexander Monro.

  • Monro, Alexander, 1773-1859.
Date:
1827
Catalogue details

Licence: Public Domain Mark

Credit: Observations on aneurism of the abdominal aorta / by Alexander Monro. Source: Wellcome Collection.

    10/34 (page 10)
    In the same manner, in cases of abscess of the lungs, the bloodvessels in the vicinity of the seat of the disease are found filled by coagulable lymph; and many other similar instances might be enumerated, did the occasion require it. With regard to aneurisms, it may be remarked, that a coa- gulum is very rarely formed until the sac has attained a very considerable bulk; and it takes place, in the first instance, in that part of the sac in which the blood is out of the direct current of circulation ; hence, a spontaneous cure will be more readily accomplished in those instances, in which a large sac communi¬ cates by a narrow neck, with an artery which is not enlarged, than in such aneurisms as are of an oval or rounded form, and are occasioned by the uniform expansion of all the coats of an artery, and in which the artery enters into the middle of the sac, as in the annexed engraving. In some aneurisms of the arch of the aorta, which I have examined, there were a number of layers of coagulable lymph within the aorta; so that though the dis¬ eased portion of the aorta was externally of much greater bulk than is natural, the channel for the flow of blood was conside¬ rably contracted. But in the case which has been described by Dr Goodison, and also in that which I met with, the coagu- lum filled up the whole cavity, and completely obstructed the vessel. In some instances, the cause of this complete fill¬ ing up of an artery is quite obvious,—it is the result of pres¬ sure. Thus, I had occasion to meet with an instance of aneurism in the arch of the aorta, in which the left arteria in- nominata was slightly thickened ; the left carotid artery was completely obstructed by a regularly organized lymph ; and the vein common to the left subclavian and left internal ju¬ gular vein, was converted, for the space of two inches, into a li¬ gamentous chord. In the case of aneurism of the abdominal aorta which occur¬ red to me, the formation of the plug, and obliteration of that ar¬ tery above the aneurism, had probably occasioned its cure. In the greater number of aneurisms no coagulum is formed, excepting within the aneurismal sac, notwithstanding which, a spontaneous cure sometimes has taken place.