Nephrectomy for a large aneurysm of the right renal artery : with a résumé of the twelve formerly reported cases of renal aneurysm / by W.W. Keen.

  • Keen, William W. (William Williams), 1837-1932.
Date:
1900
Catalogue details

Licence: In copyright

Credit: Nephrectomy for a large aneurysm of the right renal artery : with a résumé of the twelve formerly reported cases of renal aneurysm / by W.W. Keen. 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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    Case 4.—Aneurysm of the Right Renal Artery,—Leudet, CompUs rendus SodHe Biol., Paris, 1852 iv, 159, Bull. Soc. Anat, 1852, xxvii, 457, and Gaz des H6p, 1852, 583. The three references are all to the same case. The aneurysm was found at the necropsy on the body of a woman, aged 62, dying of nephritis two days after admission Her illness had existed for two years, with general debility, but no edema of the legs or face. Two months before death there was marked aggravation of the dyspnea and cough, edema and finally coma appeared before death. The right kidney was less than one-half the size of the left, which was somewhat enlarged and in the renal artery, at its bifurcation, an an- eurysm the size of a bean (haricot). Its interior was filled with semisoft, yellowish material, but no fibrin or blood. The arterial walls were calcareous. Case 5.—Small Aneurysm of the Right Renal Artery.—Dan- ner {Bull. Soc. Anaf., 1^6, xxxi, 170). The patient was a gouty man, aged 66. In the right kidney the arteries were calcareous. At the bifurcation was an aneurysm the size of a nut (noisette). The contents were of a blackish color and somewhat adherent. Case 6.—Small Aneurysm of a Renal Artery.—{Catalog Museum St. Barth. Uosp , London, 1882, i, 234, specimen No. 1536.) “ Portion of a renal artery with a small aneurysm. Earthy matter is distributed in the coats of the sac and the adjacent walls of the artery appear thickened and indu- rated.” Case 7.—Large Aneurysm of the Right Renal Artery.— Armstrong {Am. Jour Med. Sd., October, 1885, 435). Arm- strong believed the case to be unique. A man, aged 50, was admitted to the hospital comatose and died a few hours later. Necrop.xy. Free blood (300 cc.) was found in the abdomen and a large clot under the liver. The right kidney was en- larged and there was a circumscribed peritonitis around it. The capsule was ruptured posteriorly, and this was the source of the hemorrhage into the abdomen. On incision, the enlargement of the kidney was found to be due to a black, easily disintegrated clot, within ivhich lay the kidney. The clot consisted of 900 cc. of blood. “ The kidney was slightly eroded on its surface, and in the external border was a small spherical cavity, about 1 mm. in diameter The tubules were pressed away, not destroyed, and there was a well-organized fibrinous clot. This was the fons et origo of the hemorrliage; and as it contained the only well-formed fibrin that existed in the exudate, and from its shape, I con- sidered it an aneurysm of an interlobular artery.” The left kidney showed chronic nephritis. Case 8.— Vrawnalic Aneurysm of the Right R-7Uil Artery.— Turner {Trans. Path. Soc. of London, 1885, xxxvi, 277). A male, aged 19 years, was thrown from a cart on May 13. Hematuria was present from the sixth day after admis-