On obstruction of the inferior vena cava, with cases / by William Henry Battle.

  • William Henry Battle
Date:
[1888]
Catalogue details

Licence: Public Domain Mark

Credit: On obstruction of the inferior vena cava, with cases / by William Henry Battle. 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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    •where the presence of very large and tortuous veins on the surface of the body, and also, in some cases, on the lower extremities, possibly unaccompanied by any other evidence of venous obstruction, attracts the immediate attention of the observer. Eppinger1 records a case of cicatricial obliteration of the inferior vena cava, with dilatation of the superficial veins, and describes the collateral venous circulation as found post mortem. The following case, which was under the care of Mr. S. Jones, to whom I owe permission to pubhsh it, illustrates fully the point mentioned—the dilatation of super- ficial veins and other evidences of extensive obstruction to the deep veins. Case 2. Enormous dilatation of the superficial veins of the lower abdomen and thighs, with gangrene of the feet, for which amputation was performed.—The patient, J. S—, aet. 38, ship's broker, from Liverpool, was admitted on May 14th, 1881, and remained under treatment until April 5th, 1882. He was a short, rather squarely-built, but somewhat poorly nourished man, with an anxious look. He gave the following nistory. Until eight years before the date of admission he had been strong and healthy; he then had an attack of typhoid fever, and has not been well since, suffering from cold feet, &c. Three years after the attack of typhoid he had what was called by the medical man who saw him phlegmasia dolens of both legs; this was accompanied by swelling of both legs and severe pain across the lumbar region, and later by gangrene of the left foot, which was amputated a few weeks afterwards. The right foot appears to have been unaffected by gangrene until April 5th, 1881, when a small blister formed on the dorsum of the second toe. This gradually sloughed off, and then the gangrene spread to the third and fourth toes, slowly extending with much pain until admission, when there was extending gangrenous condi- tion of all the toes of the right foot, and of the base left after separation of the third; this was most marked in the third fourth, and fifth toes. There was oedema, redness, and swelling extending from the gangrenous portion up the foot and leg; there was no line of demarcation, and the thin dis- ] « Prager med. Wochenschrift,' Nos. 30, 40, 1876.