. Röntgen ray diagnosis and therapy . asis of the his-tory. In osteomyelitis, because of its transparency, a focus wouldalso have shown itself on the skiagraphic plate, and the samewould be true in the case of necrosis. There was, however, the possibility of a sarcoma of the sheathof the femoral artery, or of a fibroma, originating from the inter-muscular tissue and fascia, or of an angiolipoma. 152 THE KONTGEN RAYS In view of these diagnostic uncertainties, the author thoughtit best to resort to an exploratory incision in order to exsect aportion of the tumour for microscopical examination. A
. Röntgen ray diagnosis and therapy . asis of the his-tory. In osteomyelitis, because of its transparency, a focus wouldalso have shown itself on the skiagraphic plate, and the samewould be true in the case of necrosis. There was, however, the possibility of a sarcoma of the sheathof the femoral artery, or of a fibroma, originating from the inter-muscular tissue and fascia, or of an angiolipoma. 152 THE KONTGEN RAYS In view of these diagnostic uncertainties, the author thoughtit best to resort to an exploratory incision in order to exsect aportion of the tumour for microscopical examination. After making an incision alongside the inner margin of thesartorius muscle, the fibres of the vastus internus muscle weredivided with great care. But in spite of these precautions, a jet ofarterial blood sprang up, and now the riddle was solved. A largefemoral aneurysm was situated above the adductor. By forciblepressure the haemorrhage was stopped until Esmarchs bandagewas applied, and the author ligated the femoral artery in Scarpas. Fig. 102.—Popliteal Aneurysm, showing Phlebolith. triangle. The large sac, which was entirely filled up by fibrin-clots,was now exsected. It seems probable that the aneurysm was of traumatic origin, PELVIS AND LOWER EXTREMITY 153 dating from the injury sustained three years ago. The arterialwalls having been squeezed and partially crushed, the arterybecame dilated; and from the enormous thickening of the sac itwould seem that thisdilatation was followedby abundant cell-prolif-eration in the arterialwalls and their was also an enor-mous amount of palefibrin in tough of the fibrin clotsshowed the circulatorychannel, the calibre ofwhich was much small-er than that of a nor-mal femoral artery. Allthese points would ac-count for the absence ofpulsation. While in this casethe Kontgen rays failedto give any positive in-formation as to thecharacter of the tu-mour, the shadow caused by the aneurysm being so slight thatinterpret
Size: 1421px × 1759px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, bookpublishernewyo, bookyear1904
