Diseases of the kidney which require surgical operation : illustrated by three cases / by W. Morrant Baker.

  • William Morrant Baker
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the kidney which require surgical operation : illustrated by three cases / by W. Morrant Baker. 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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    DISEASES OF THE KIDNEY WHICH REQUIRE SURGICAL OPERATION I.—A case of Nephrotomy, in which Nephrectomy was subsequently per- formed. II.—A case of Nephrotomy. III.—A case of Renal Lithotomy. Case I.—A case of Neph/rotomy, in which Nephrectomy was subsequently per- formed.—For the detailed notes from which the following abstract has been made, I am indebted to Dr. Hale White, House-surgeon, and Mr. H. Fraser Stokes, Registrar to the Evelina Hospital.] The patient, a girl (A.P.), seven years old, was admitted into the Evelina Hospital for Sick Children, under the the care of Dr. Buchanan Baxter, October 8, 1880. She was said to have been always delicate, but free from any serious illness until about eighteen months before her admission into the hospital, when a large quantity of blood, in part coagulated, was passed with the urine. No more blood was noticed until about a year after the first hsemorrhage, when she again had an attack of hsematuria, but less severe. No blood has been passed since ; but at about the same time it was noticed that the urine became purulent; and this condition remained up to the date of admission. For several months, and before the second attack of hsematuria, she had become languid, and complained of pain in the chest. She also perspired much at night and lost flesh. At the time of the child’s admission into the hospital, a rounded swelling of somewhat indefinite character was found in the abdomen—deeply seated in the region of the right kidney—dull to percussion, and not very tender, varying in size from to time. The urine was pale and contained a large quantity of pus, and sometimes blood. It was passed frequently, and in small quantities at a time. Hectic fever was very marked. Temperature 104° F. at night, 97° F. in the morning. Six weeks after admission the quantity of pus in the urine had become doubled; and on one occasion, at about this period, half-a-pint of blood-red urine was passed. Eight weeks after admission her appetite failed, hectic fever became more marked, and the patient was evidently becoming weaker. December 7, 1880.—As the result of a consultation with Dr. Baxter, I per- formed nephrotomy at this date, an incision being made parallel to and below the last rib, as for lumbar colotomy. The kidney was exposed without any special difficulty and incised; and the interior of the organ, which was found much sacculated, was explored with the finger. No stone was detected. A drainage-tube was inserted into the kidney, and the wound, which had been made under the carbolic spray, was dressed in the usual manner.