The surgery of blood-cysts of the suprarenal body / by Alban Doran.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927.
Date:
1908
Catalogue details

Licence: In copyright

Credit: The surgery of blood-cysts of the suprarenal body / by Alban Doran. 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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    TV The Medical Brief A Monthly Journal of Practical Medicine. Vol. XXXVI. St. Louis, Mo., August, 1908. No. 8. THE SURGERY OF BLOOD-CYSTS OF THE SUPRARENAL BODY. By Alban Doran, F. R. C. S., England. Senior Surgeon to the Samaritan Free Hospital, London. [Written for the Medical Brief.] Hemorrhages in the substance of the suprarenal body are well known to pathologists and physicians. They have been detected in necropsies of children who have died suddenly during a fit of coughing. Twenty years ago Dr. Herbert Spencer, now obstetric physician to University College Hospital, London, collected 130 reports on necropsies on stillborn children, all under his own observation, in the maternity department of that institu- tion. In fifty-three cases either congestion or hemorrhage was detected in the suprarenal bodies. In twenty-four the bleeding lay in the medullary portion, and it was found that delivery by the lower pole, especially when traction is employed, distinctly favors this form of injury. We may assume that many children survive these medullary hemor- rhages, especially if unilateral. If so, may not further morbid changes develop in the suprarenal body damaged so early in life? Under what conditions may these hemorrhages begin in the adult? We know better how they may end. There is a class of tumors known as blood-cyst of the suprarenal body. Henschen and others have written on it. Indeed, as will be seen, it was recognized by the clinician, as distinguished from the pure pathologist, long before the days of abdominal surgery. The blood-cyst is to the surgeon the most interesting form of cystic tumor known to develop in the suprarenal body. I have collected nine cases, including one in my own operative experience. My patient was a woman, sixty-two years of age. She had been subject for ten years to epigastric pain and for several months to sharp attacks of pain, referred to a firm, oval tumor in the left hypochondrium. The upper part lay under the ribs, but the tumor could be pushed downwards till the upper pole was entirely below them, and then there was resonance on percussion over part of its anterior surface. The patient was fairly well nourished, with a ruddy complexion, free from bronzing. The epigastric pains appeared to be due to dyspepsia, caused by excess in tea-drinking, so common amongst the poor of London. I removed the tumor in October, 1907, opening the abdomen through an incision along the outer border of the left rectus.