Notes of cases illustrating surgical lesions of the vascular system / by Rudolph Matas.

  • Matas, Rudolph, 1860-1957.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Notes of cases illustrating surgical lesions of the vascular system / by Rudolph Matas. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    11/35 (page 7)
    as the reduction of the intra-pharyn^eal portion had facili- tated speech and deglutition. The effect on the size of the tumor was disappointing, however, as, even now, after two two years’ observation, I find that the tumor remains, only smaller in size, though it does not pulsate nor appear to grow. 1 am therefore inclined to believe that this is really a case of tonsillar fibro-adenoma, which has been reduced and kept dwarfed through arterial fasting. Observation 4.—Enormous traumatic aneurism of the com- mon femoral, simulating an aneurism of the external iliac. Sac filled the thigh and the whole iliac fossa, pushing up the external iliac and femoral, almost causing spontaneous cure through upward pressure of the overlying iliac artery. Laparotomy ; ligation of the external iliac mid- way between Poupart’s ligament and origin ; aseptic heal- ing. Death from anemia and exhaustion one week after operation. Autopsy reveals a cavity containing fully one gallon of clot. This patient, a young mulatto, aged 23, was admitted in Ward 2, June, 1892, presenting an exceedingly wasted and anemic appearance. He had a tumor which filled the right iliac fossa, the inguinal and upper femoral and obturator re- gions. The swelling was semi-elastic, tense, full, covered by a glazed skin; there was no sense of fluctuation except at inner half of base of Scarpa’s triangle, where a soft spot existed, in which a slight thrill and murmur could be perceived. The first impression caused by the appearance of this tumor was that of a tubercular abscess. But the histoiy of traumatism (a gunshot injury'sustained several months before), carefully elicited by^ Mr. Brady (Dr. C. Milo Brady, of Gretna), in- terne of the service, convinced us that we were dealing with a large traumatic aneurism. The solid, elastic feel indicated that the sac had filled with a large mass of clot and that the circulation within it was quite sluggish. The exact point of communication of the sac with the artery of supply could not be ascertained, but owing to the ex- tension of the tumor above Poupart’s ligament we concluded that the common femoral was injured on a level with the ligament