Four cases of aneurism of the arch of the aorta, and a case of diaphragmatic hernia / by John Reid.

  • John Reid
Date:
[1840]
Catalogue details

Licence: Public Domain Mark

Credit: Four cases of aneurism of the arch of the aorta, and a case of diaphragmatic hernia / by John Reid. 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.

    9/18 page 9
    ty large openings, related by Dr Henderson in No. 127 of this Journal, are preserved in the University Anatomical Museum. Case IV.—Aneurism of the Aorta bursting ewternally.— ,T. P. aged 31, a mason, of temperate habits, was admitted, 7th August 1839, under the charge of Dr Shortt. Stated that, about six years ago, he began to complain of pain behind the upper part of sternum ; that about twelve months after this, a tumour about the size of a nut presented itself near the sternal end of right clavicle ; and that he has been occasionally troubled with dyspnoea, but not with palpitation. On admission there was a pulsating tu- mour, rising and falling with the systole and diastole of the heart, placed at the junction of the right clavicle with the sternum. The tumour was of a pyriform shape, projected about three inches in front of the sternum, and was about three inches and a-half in cir- .cumference. There was a loud bruit heard over the tumour, and a bruit also accompanied the sounds of the heart. Impulse of the heart strong, and felt below the sixth rib ; complained of some pain in the region of the tumour. Of an athletic form of body, and general health good. J-*ulse 72, full and throbbing; no dyspncea when quiescent, and appetite good; was ordered to be bled, and - to take digitalis and colchicum. The tumour continued to in- crease in circumference, and there projected from its anterior surface ft smaller tumour, measuring about three inches in circumference, and was prolonged outwards two inches beyond the surface of the broader tumour placed below. The pulsation was less strongly felt in the projecting portion than in the broad part of the tumour, but the skin covering the apex of it became first livid, and then of a dark-colour, and presented the appearance of incipient slough- ing. On the 3d of September some oozing of blood took place from the apex of the projecting part. On the following day about two ounces escaped ; and on the afternoon of the 4th, a sudden rusli of arterial blood took place when he was straining at stool, and he soon ceased to breathe. The heart continued to beat for a few minutes after the respiration had ceased, and about four pounds of blood (to judge by the eye) had escaped. Sevtio Cadaver is, 6th.—On opening the thorax, a large aneur- ismatic dilatation was found in the anterior mediastinum. This dilatation was formed by the aorta, and included all that part of the vessel placed between its origin from the heart, and where it lies on the fourth vertebra. The most dilated part was near the origin of the arteria-innominata, and would readly have contain- ed two fists. The walls of tliis dilatation were every where form- ed by the coats of the artery, except at the part behind and to the right side of the sternum. The middle coat of the artery was much thickened, and contained several calcareous plates at differ- ent parts. There was a rounded opening in the wally of the sac.
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