Modern surgery, general and operative (1914) (14596101447)

Identifier: modernsurgerygen1914daco (find matches)
Title: Modern surgery, general and operative
Year: 1914 (1910s)
Authors: Da Costa, J. Chalmers (John Chalmers), 1863-1933
Subjects: Surgery Surgery, Operative
Publisher: Philadelphia, London, W. B. Saunders company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons



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re was no increase of arterial tension. The patient died. Another case 1274 Diseases and Injuries of the Genito-urinary Organs was a woman of forty-five who was brought to the Jefferson Hospital. Shehad suffered from pain in the loin for months. It was paroxysmal, but lackedthe radiation of renal colic. Hematuria appeared long after the pain hadbegun. It was persistent, but small in amount. Palpation detected a tumorand the x-rays showed enlarged kidney. There was no increase of arterialtension. Recovery followed nephrectomy. In a man, aged thirty-four, in thePhiladelphia Hospital there were attacks of severe pain referred to the groin,testicle, and loin. The bleeding was profuse. A mass was palpable in the rightupper abdomen and loin. Examination of blood showed hemolysis, but therewas no hypertension. The growth was exposed in the loin. Hemorrhage wasso violent that it became necessary to open the abdomen and ligate the renalpedicle. The kidney was removed and the patient recovered.
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.—Sarcoma of kidney with metastasis (Horwitz). Very malignant cases have proved fatal within six weeks after symptomswere observed. Some patients have lived three years. A hypernephroma ofmalignant nature involves adjacent structures, and gives rise, after a time, tometastases, particularly by way of the blood. The bones are most liable tometastatic deposit, but such deposits may occur in the limgs, liver, and otherregions. In a case upon which I operated for a supposed adenomatous goiterthe condition was really metastatic hypernephroma. Hypernephromata areinfinitely more common in the kidney than anywhere else. They tend par-ticularly to occur in middle life. Sarcoma or carcinoma may arise in the kidney.Sarcoma is most common in the young, and may reach an enormous size(Fig. 849). A malignant tumor of the kidney produces hematuria, the urineoften containing blood-casts of the ureter, kidney, and pelvis, and sometimes,though rarely, characteristic cells. Pain is often present in the