Case of cystic tumour attached to kidney simulating ovarian disease, extirpation of kidney, recovery / by A. Campbell.

  • Campbell, A.
Date:
1874
Catalogue details

Licence: Public Domain Mark

Credit: Case of cystic tumour attached to kidney simulating ovarian disease, extirpation of kidney, recovery / by A. Campbell. Source: Wellcome Collection.

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    with in the following way :—An incision about five inches in length, from an inch below the umbilicus downwards, was made in the middle line. The skin, fascia, and muscles were rapidly divided, and the peritoneum having been displayed, was divided on a director. The cyst was now reached, and the edges of the wound were held so as to prevent the escape of the contents into the abdomen after puncturing. The cyst had a multilocular appearance and was of a whitish colour. About three-fourths of it was covered by peritoneum. A large ovariotomy trocar, with several feet of indiarubber tubing attached, was plunged into the cyst, but, though firm pressure was applied, and kept up steadily for a minute or two, no fluid escaped. On withdrawing the trocar it was found that the cyst contents were of the consistence of porridge. In these circumstances, the cyst was laid open and its contents cleared out, which amounted to about 2J pints. The cyst was now dragged forward, but was found to be firmly fixed and attached posteriorly. A minute examination of the interior of the abdomen showed, to our great surprise, that both ovaries were in their natural situation, and of normal size. A little further examination served to show that the tumour, which was the cause of the operation, was a large cyst attached to, or rather thoroughly incorporated with, the lower end of the left kidney. As matters stood, it was at once determined to remove both kidney and cyst. A portion of intestine and omentum, which were very firmly adhe¬ rent to the posterior part of the tumour, were carefully separated by . the fingers ,* the left ureter and the renal vessels were tied with a strong hempen thread, and the kidney along with the tumour removed. There was considerable oozing, but little free bleeding, from the bed of the tumour. Four omental vessels were seized and tied with Lister’s carbolized catgut ligatures, and the interior of the abdomen was carefully cleaned with sponges previously soaked in an aqueous solution of carbolic acid, and latterly in warm water. Deep sutures of silk thread, and superficial of horse-hair, were alternately used, for closing the wound, which was covered with a pad of antiseptic gauze and lint. The patient was then removed to bed, and two hours afterwards a half-grain morphia suppository was administered. The tumour was found to be caused by cystic degeneration of the lower fourth of the kidney, of which the other parts had the appear¬ ance of health. 6 P.M.—Very feeble. Complains of cold, though extremities feel quite warm. Pulse 100 ; temp. 98'4°. 9.30 P.M.—Urine drawn off by catheter. Has retched a little. Has had a little iced brandy-and-water. I\ Pulveris opii gr. i. every four hours. 3d Dec.—Morning—Pulse 132 ; temp. 100*6°. To have enemata of beef-tea and egg-flip; milk, beef-tea, and iced brandy by mouth if possible.