A phenomenal aortic aneurysm / by W. Gilman Thompson.

  • William Gilman Thompson
Date:
1908
Catalogue details

Licence: In copyright

Credit: A phenomenal aortic aneurysm / by W. Gilman Thompson. 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.

    6/14 (page 4)
    the mass, as felt through the abdominal wall, was explained by the variations in thickness of the aneurysmal sac and the unexpected position of the imbedded kidneys. After eight days in hospital, the patient died from edema of the lungs and brain. The autopsy, per- formed by Dr. Meakins of the pathological depart- ment, is summarized as follows: Autopsy.—The liver, which weighed only 1,000 grams, was thin and flattened against the anterior abdominal wall; it occupied a normal position, and showed fatty degeneration. The spleen weighed 200 grams, and was bound in the normal position by ad- hesions. Both kidneys lay below the umbilicus, the right being a couple of inches above Poupart’s liga- ment, and both were in contact with the abdominal wall, imbedded in a mass of connective tissue; they weighed 50 grams each, and the capsules were ad- herent. To remove the aneurysm entire the psoas and iliacus muscles had to be removed upon both sides, leaving only the skin of the posterior abdom- inal wall. The aneurysm occupied the entire pos- terior part of the abdomen, extending from the diaphragm to the lower border of the sacral prom- inence, in the median line, and reaching down on either side as far as Poupart’s ligament. On re- moving the large laminated clots which filled most of the cavity, the wall of the aneurysm was found composed of the intima, the other arterial coats be- ing indistinguishable excepting over a very small area. The aneurysm appeared to have originated from the posterior wall of the abdominal aorta, not from any of its branches. Five vertebrae were eroded, viz., the eleventh and twelfth dorsal, first, second, and third lumbar. The first lumbar verte- bra was so deeply eroded that the meninges were