Case of a ruptured external iliac aneurism treated by ligature of the common iliac artery / by A.M. Edwards.

  • Edwards, A. M. (Alexander Mackenzie)
Date:
[1858]
Catalogue details

Licence: Public Domain Mark

Credit: Case of a ruptured external iliac aneurism treated by ligature of the common iliac artery / by A.M. Edwards. Source: Wellcome Collection.

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    CASE OP / A EUPTUEED EITEENAL ILIAC ANEUEISM, -TREATED BY LIGATURE OE THE COMMON ILIAC ARTERY. By a. M. EDWAKDS, Esq., F.K.C.S.E.^ [kEPEINTED from the EDINBURGH MEDICAL JOURNAL, JANUARY 1858.] On June 19tli, I was brought by Dr Brodie of Gayfield Square to see Donald McDonald, a discharged soldier, aet. 27, of sanguine temperament, muscular and well-formed. He had been discharged on account of deafness, from a Highland regiment, in which he had served during the Crimean campaign, Hiotory. which he had twice attained the rank of sergeant, and been as often reduced to the ranks for drunkenness. Three months ago he re¬ marked a tumour the size of an apple, pulsating in his right hypogastrium ; and within the last few days has been troubled with pain and swelling of the right foot and leg, which he thought w'as brought on by the long distances his scanty supply of money obliged him to travel on foot. On the morning of June 18th, the pain in his groin was more severe, and he was bathing the part with cold water, when he suddenly felt something give way in his abdomen, and the pain greatly increased, while at the same time, there was a sensation of warm fluid flowing towards the seat of pain. Dr Brodie was quickly on the spot, and found him with a cold surface and a scarcely perceptible pulse, very faint, and appa¬ rently dying from internal haemorrhage. He rallied, however, and with the view of lessening the arterial impulse, and the likelihood of a recurrence of the bleed¬ ing, Dr Brodie prescribed tincture of aconite, perfect rest and quiet, with absti¬ nence from stimulants and animal food. There was now a distinct tumour, ex¬ tending upwards from Poupart’s ligament towards the level of the umbilicus, with no defined limits, but distinct pulsation. The patient complained of in¬ tense pain and tension of the abdomen. He lay quiet for several hours, when he suddenly expressed a wish to micturate, and when attempting to do so, fainted. He again rallied, and the remedies were continued. I saw him about noon the following day, with Dr Brodie, who I found was of opinion that the tumour was an iliac aneurism, and that Drs Coldstream and Littlejohn were also of this opinion ; but as none of those gentlemen had seen the tumour before its outline became diffused, they could not determine as to its exact situation. As it was clear, however, that, wherever the aneurism might be, it had burst, and the man was likely to bleed to death, I informed Dr Brodie, that, with his concurrence, and if urgent symptoms again set in, I should have no hesitation in putting a ligature round the common trunk, as that, though a desperate remedy, alone gave the poor fellow a chance of life. He was in great ^ Read before the Medico-Chirurgical Society, Nov. 18, 1857.