Successful case of nephrorraphy for floating kidney. Uncompleted nephrectomy / by W.W. Keen.

  • Keen, William W. (William Williams), 1837-1932.
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Successful case of nephrorraphy for floating kidney. Uncompleted nephrectomy / by W.W. Keen. 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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    UNCOMPLETED NEPHRECTOMY. CALCAREOUS VESSEL MISTAKEN FOR A CALCULUS BY THE NEEDLE TEST. OPERATION ABANDONED ON ACCOUNT OF ADHE- SIONS. DEATH. AUTOPSY. PRIMARY ENGEPH- ALOID OF THE KIDNEY. By W. W. keen, M.D., PROFESSOE or SUROERT IN THE WOMAN'S MEDICAL COI.LEfiE OF PENNSYLVANIA. [Read March 27, 1889.] G. M. C, aged sixty-eight, weight one hundred and sixty-four pounds, six feet two inches tall, was sent to me through the kindness of Dr. E. W. Wat- son, on October 31, 1888, with the following history. On April 6, 1886, he had an attack of retention of urine. Violent expul- sive efforts forced out a clot. The bleeding continued two or three days. With this he had pain in the right lumbar region. A month later another similar attack occurred, the pain on this occasion being quite severe and amounting to a distinct renal colic. Other attacks, always accompanied by pain and bleeding, occurred in July, 1886, and in January, September, and November, 1887. After the last one, for several weeks he had repeated and nearly continuous hematuria with a sensation of heat in the right lumbar region, and he lost strength and appetite. January 14, 1888, he was taken extremely ill with pleuro-pneumonia and septicemia. Both legs were attacked with phlegmasia. The dulness in the right kidney, Dr. Watson stated, was increased, but no pus was found in the urine either then or at any other time; neither were any symptoms located in the bladder. This illness lasted about two months. In May and June of 1888 he again had attacks of hematuria, and from September 17 to October 31, 1888, he has had nine attacks, passing as much as six or eight ounces of blood, he thinks, in some of the attacks. He has never passed any calculus. In the interval between the attacks the urine was clear. No cause can be assigned for the attacks ; not uncommonly they have come on while he was lying in bed. He states that the right kidney is now the seat of marked aching pain. Present condition.—He is a very tall man with a disproportionately long chest; from the ribs to the crest of the ilium the space is barely two fingers in breadth. The bladder was sounded, but no stone was found. Its walls were rugose. The prostate not much, if at all, enlarged. Eenal dulness on the