. Lectures on the diagnosis of abdominal tumors, delivered to the post-graduate class of Johns Hopkins university, 1893. n of the liver, spleen, and other parts of theabdomen is negative. The diagnosis of aneurysm of the abdominal 158 THE DIAGNOSIS OF ABDOMINAL TUMORS. aorta was made by Dr. Hewetson, under whose care the patient first came, and subsequently when I saw him the doubt arose in my mind, owing to the extreme mobility,whether it was really in the aorta, orwhether it might not be connectedwith one of the branches—the tumorseemed remarkably mobile, and couldbe pushed so far from left
. Lectures on the diagnosis of abdominal tumors, delivered to the post-graduate class of Johns Hopkins university, 1893. n of the liver, spleen, and other parts of theabdomen is negative. The diagnosis of aneurysm of the abdominal 158 THE DIAGNOSIS OF ABDOMINAL TUMORS. aorta was made by Dr. Hewetson, under whose care the patient first came, and subsequently when I saw him the doubt arose in my mind, owing to the extreme mobility,whether it was really in the aorta, orwhether it might not be connectedwith one of the branches—the tumorseemed remarkably mobile, and couldbe pushed so far from left to Halsted, too, thought that the tu-mor might possibly be in one of thebranches; and as the patient con-sented he did an exploratory opera-tion. The tumor was found to springdirectly from the aorta just above therenal arteries. The pedicle of the sacwas short and almost as wide as theaneurysm itseK. It was thought bet-ter to leave the case to Nature than toattempt any measures to promote con-solidation in the sac. The patient recovered rapidly from the operation and left the hospital in about ten Fig. 38.—Position of the dotted outlines illustrate theextreme mobility. Case LVI. Aneurysm of the abdominal aorta is rare. This is thefirst one which has been under our observation since thehospital was opened, during which time there have beenbetween forty and fifty aneurysms of the thoracic aortain the wards. The diagnosis here was readily made ; thetumor was so pronounced, so rotund, so expansile in alldirections, and with a well-marked thrill and systolicbruit—no single feature of aneurysm was absent. Themobility alone was unusual; not one of the few aneurysmsin this situation which I have seen presented such remark-able mobility. A few weeks subsequently I saw in Montreal with a patient who had progressive ansemia and de-bility with great abdominal distention and pain. An ab- MISCELLANEOUS TUMORS. 159 domiual tumor had been suspect
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