New management of apparently uncontrollable hemorrhage from the kidney during nephrotomy / Geo. I. Miller.

  • Miller, George I.
Date:
1907
Catalogue details

Licence: In copyright

Credit: New management of apparently uncontrollable hemorrhage from the kidney during nephrotomy / Geo. I. Miller. 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.

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    Reprinted from the American Journal of Surgery, December, 1907. NEW MANAGEMENT OF APPARENTLY UNCONTROLLABLE HEMORRHAGE FROM THE KIDNEY DURING NEPHROTOMY. Geo. I. Miller, M.D., Instructor in Operative Surgery, Post-Graduate Medical School and Hospital, New York; Attending Surgeon, St. Mark’s Hospital, New York; Associate Surgeon, Jewish Hospital, Brooklyn, N. Y. BROOKLYN, N. Y. Hemorrhage from the kidney when incised is a frequent occurrence and has often taxed the in- genuity of the operator to successfully control the bleeding organ. The typical anatomical circulation of the kidney is sufficient in itself to suggest that an incision through its substance must result in an abundant outflow of blood. For a better understanding of what is to follow it will not be out of place to review the blood supply of the kidney; this I find very clearly described in Vol. V of E. Von Bergmann’s System of Surgery, and is as follows : The chief vessel of the kidney, and the only one which enables it to perform its functions, is the renal artery. This vessel, whose diameter (6 cm.; 2.4 inches), is quite out of proportion to the size of the organ, springs at right angles from the abdominal aorta and usually divides into four branches before it enters the lulus of the kidney. Two of these branches enter the anterior portion of the organ, and two of them the posterior portion. This is the usual distribution. Jossel describes the renal artery as dividing into two anterior, one superior, and one