. A manual of operative surgery . 4.)Symptoms may not arise until adult life, and the diagnosiscan only be made by an exploratory measure. Foetal lobula-tion is always persistent in such cases. The renal ar- teries are end arteries, so thatwhen they are cutacross, the tissuessupplied by thecut vessel undergonecrosis. There are con-stantly present anumber of finearterial twigs sup-plying the capsuleand ■ even part ofthe cortex of thekidney, which arenot derived fromthe true renalarteries, but comefrom the lumbaror suprarenal ves-sels. In the cases of congenital displacement of the kidneymention
. A manual of operative surgery . 4.)Symptoms may not arise until adult life, and the diagnosiscan only be made by an exploratory measure. Foetal lobula-tion is always persistent in such cases. The renal ar- teries are end arteries, so thatwhen they are cutacross, the tissuessupplied by thecut vessel undergonecrosis. There are con-stantly present anumber of finearterial twigs sup-plying the capsuleand ■ even part ofthe cortex of thekidney, which arenot derived fromthe true renalarteries, but comefrom the lumbaror suprarenal ves-sels. In the cases of congenital displacement of the kidneymentioned below, the main renal arteries may be derived fromthe common or internal iliac vessels or even in part from themiddle sacral (which is a rudimentary prolongation of theabdominal aorta). With regard to the veins of the kidney, it should be notedthat there is a fine network all around the organ which com-municates with the lumbar, suprarenal, spermatic, ovarian, andphrenic veins, and those accompanying the adjacent last dorsal. FIG. 134.—HYDRONEPHROSIS CAUSED BY KINKING OF URETER(U) OVER AN ABERRANT RENAL ARTERY (a) AND VEIN. [Specimen prepared and drawn, by Mr. F. S. Kidd.) K, Elongated kidney with congenital lobulations persisting ;P, Greatly dilated pelvis ; v, Trunk of renal vein ; A, Upperand main part of renal artery. In such a case, operationand division of the aberrant renal vessels between twoligatures will result in cure. 484 ABDOMINAL OPERATIONS [part ii and lumbar nerves. Hence when the kidney is detached fromits fatty capsule there is usually considerable venous oozing,which needs careful attention before the wound is closed. The renal veins do not take the same course as the arteries(see Figs. 138 and 139). Their distribution within the kidneyis different, and corresponds to the arrangement of the all pass in front of the pelvis, and join to form a singletrunk which passes transversely inwards to enter the vena vessels enter the vena c
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