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Movable Kidney and Hydronephrosis

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MOVABLE KIDNEY AND HYDRONEPHROSIS.

Dr. Deaveralso reported the case of a woman, aged twenty one years, who was first attacked with dull aching pain in the left loin in November, 1896, since which time she has had numerous attacks of this pain, at times associated with nausea and vomiting. Immediately following the attacks of pain blood would appear in the urine, but an X-ray examination was negative. December 14, 1899, a vertical incision, three inches long, was made in the loin over the left kidney. The perirenal fat was dissected away and the kidney exposed. On examination, the pelvis of the ureter and the first part of the ureter were found to be dilated to the size of a small lemon. There was no stone present. The dilated portion of the pelvis and of the ureter was incised in the long axis of the ureter and clear fluid evacuated. The surplus portion of ureter was cut away and the wound sutured. The kidney was explored for stone, but none found. The surface of the kidney was scarified and the organ anchored in the wound with gauze. The patient made a satisfactory recovery.

A second case of movable kidney was in the person of a man, aged twenty-four years, who, after convalescing from an opera tion for chronic appendicitis, returned to the hospital to obtain relief from pain in the left renal region from which he had suffered intermittently for several years. The patient can only recall the pain, and say that it was excruciating, and that it did not extend into the penis or along the course of the ureter.

The second severe attack of pain, referred to left renal region, occurred while the patient was convalescing from his operation for appendicitis, and had the characteristics of kidney colic ; the pain was referred down the course of the ureter and into the testicle of the corresponding side. This attack was not accom panied by nausea or vomiting, nor was the urinary examination attended by any positive results. The pain persisted, and shortly after the onset urination was attended by pain. Urinary ex amination, also X-ray examination negative. A vertical incision of three inches was made in the loin, commencing at the border of the twelfth rib at the postaxillary line, on the left side, the perirenal fat was broken through, when it was discovered that the kidney held a lower plane than normal. The kidney was brought into the wound and explored with a negative result. The kidney was anchored in the wound with gauze. The wound was packed with sterile gauze after the method of treating movable kidney. Recovery followed.

pain, ureter, wound and left