Symmetrical necrosis of the cortex of the kidneys associated with suppression of urine in women shortly after delivery / by H.D. Rolleston.

  • Humphry Rolleston
Date:
[1913?]
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Licence: In copyright

Credit: Symmetrical necrosis of the cortex of the kidneys associated with suppression of urine in women shortly after delivery / by H.D. Rolleston. Source: Wellcome Collection.

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    With the Writer's Compliments. Reprinted from The Lancet, October 25, 1918 SYMMETRICAL NECROSIS OF THE CORTEX OF THE KIDNEYS ASSOCIATED WITH SUPPRESSION OF URINE IN WOMEN SHORTLY AFTER DELIVERY. By H. D. ROLLESTON, M.D. Cantab., F.R.C.P. Lond., SENIOR PHYSICIAN, ST. GEORGE'S HOSPITAL ; PHYSICIAN, VICTORIA HOSPITAL FOR CHILDREN. Symmetrical necrosis of the cortex of the kidneys is rare and is almost only seen in women directly after childbirth, in whom ten cases have been reported (Bradford and Lawrence,1 Griffith and Herringham,2 Lloyd,10 Klotz,9 Jardine and Teacher0 (2 cases), Torrens,12 and Jardine and Kennedy 7 (3 cases)). The one recorded below brings the total up to 11. (See Table I.) The ages of these 11 patients varied between 22 and 48 years. Nine were multigravidae, one was a primipara, and in one case there was not any statement. In one case only was there a live birth (Jardine and Kennedy, Case 2) and in that instance there were live twins. The exception to the statement that symmetrical necrosis of the renal cortex is a puerperal manifestation is that in very rare instances embolic infarction may be so extensive as to produce this anatomical lesion. Juhel-Renoy8 described symmetrical necrosis of the renal cortex in a girl, aged 16 years, after scarlet fever, due to microscopic emboli in the interlobular arteries. The clinical features are remarkable in resembling in the main those of calculous obstruction of both ureters rather than those usually regarded as characteristic of non-obstructive anuria. Although urmmic manifestations were absent in some of the reported cases and when present were usually comparatively slight, analysis of the 11 collected cases does not justify the statement sometimes made that uraemia is constantly and entirely absent. Dyspnoea occurred in 3 cases (in Jardine and Kennedy’s first case, in Klotz’s case, and in my case); Jardine and Kennedy’s second patient vomited and for 24 hours before death was semicomatose ; their third patient vomited and had hiccough ; Griffith and Herringham’s patient vomited frequently and had headache during the earlier days of the illness, but
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