Mt Sinai Hospital Reports . l veins were markednot only in the affected leg, and particularly the thigh, but therewas marked edematous infiltration of the left side of the anteriorabdominal wall and loins. Indeed the slight swelling of the otherleg caused us to suspect that the thrombus had extended into thevena cava, thus interfering with the return of blood from the rightcommon iliac vein. We looked anxiously for the appearance ofblood in the urine to indicate the extension of the thrombus highenough up to interfere with the venous return from the kidneys, butthis symptom of a passive venous
Mt Sinai Hospital Reports . l veins were markednot only in the affected leg, and particularly the thigh, but therewas marked edematous infiltration of the left side of the anteriorabdominal wall and loins. Indeed the slight swelling of the otherleg caused us to suspect that the thrombus had extended into thevena cava, thus interfering with the return of blood from the rightcommon iliac vein. We looked anxiously for the appearance ofblood in the urine to indicate the extension of the thrombus highenough up to interfere with the venous return from the kidneys, butthis symptom of a passive venous congestion of the kidneys did notoccur. The urinary symptoms were at no time such as to warrantsuch a suspicion. Schlesinger states, however, that thrombosis of theinferior vena cava can occur and yet the edema be only presentin one extremity and corresponding side of the abdomen, there beingonly one common iliac obstructed, the other being open and discharg-ing its blood through the collateral circulation (H. Schlesinger:. 92 MOUNT SINAI HOSPITAL KKFOKTS. Deutsch. Med. Wochenschrift, L896, No. 2!>: />n- Viag. der ErkranJader V. Cava Inferior). It was hoped in ilns patienl thai the collateralvenous circulation, through tlic superficial vessels of llic abdomenand back communicating with those of the other side and the deepsuperficial veins of the upper part of the thorax, would be sufficientgradually to admit of at least a partial venous return from the legand thigh. This did really occur in the thigh; but the symptomsin the- leg very soon indicated, as the history of the case has shown,that moist gangrene had set in. Amputation was delayed partlyfor the purpose of determining how much of the extremity wouldhave to be removed, and partly because the patient refused his con-sent for amputation long after it had been determined to operation was done by Dr. A. G. Gerster on October 20, the following are the facts essential for our purposes in the histor
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