. Surgery, its principles and practice . ccord-ing to Landau, A^estiges of paren-chyma of functional capacity arefound except in extreme maintains the same viewafter examining four himdred and seventy-three reported cases, of which in only eleven was there arecord of total disappearance of kidney tissue. In old-standing casesthe cyst wall is noted for the firm adhesions which attach it to contiguousparts. The size of the cyst is at times enormous. In one case 36,000 fluid were removed (Koenig). With the development of the cj^st,neighboring organs are compressed or displaced
. Surgery, its principles and practice . ccord-ing to Landau, A^estiges of paren-chyma of functional capacity arefound except in extreme maintains the same viewafter examining four himdred and seventy-three reported cases, of which in only eleven was there arecord of total disappearance of kidney tissue. In old-standing casesthe cyst wall is noted for the firm adhesions which attach it to contiguousparts. The size of the cyst is at times enormous. In one case 36,000 fluid were removed (Koenig). With the development of the cj^st,neighboring organs are compressed or displaced and death ensues frompressure on the diaphragm. The ureter always participates in the distention above the it is as large as the finger, and in exceptional cases it has been foimdas large as the small intestine. When valve formation due to high inser-tion of the ureter is the cause of the hydronephrosis, the ureter is almostinvariably found in close relation with the anterior wall of the sac and nearits median Fig. 123.—Hydronephrosis. 222 SURGERY OF KIDNEY, URETER, AND SUPRARENAL GLAND. The contents of an aseptic hydronephrosis are, as a rule, hmpid andclear, of low specific gravity, and in the beginning of uriniferous the atrophy of the parenchyma progresses in old-standing cases thelikeness to urine gradually is lost. In many cas*es hemorrhage into thesac changes the appearance of the contents. Symptoms and Prognosis.—The course of hydronephrosis varieseven in the individual case accordmg to the patency or the occlusion ofthe ureter. As long as the ureter is open from time to time the renaldistention may diminish or disappear entirely, later to recur. In othereases drainage from the pelvis is continuous but insufficient. In themdistention occurs notwithstanding the continued discharge of some urineinto the bladder. For these the terms intermittent and openhydronephrosis may l^e used, whereas the term closed hydronephrosisis reserved fo
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