Identifier: transactionsofam2519amer (find matches)
Title: Transactions of the American Association of Obstetricians and Gynecologists for the year ...
Year: 1912 (1910s)
Authors: American Association of Obstetricians and Gynecologists
Subjects: American Association of Obstetricians and Gynecologists Gynecology Obstetrics Gynecology Obstetrics
Publisher: Philadelphia : The Association
Contributing Library: Columbia University Libraries
Digitizing Sponsor: National Endowment for the Humanities (NEH)

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did not see this boy again until August 9, on theoperating table, as a belated steamboat had landed him, accom-panied by his family physician. Dr. H. S. Rowlett, of CarrollCounty, Ky., in Louisville late the night before. I made anincision along the outer border of the right rectus muscle, 5inches long, down to the cyst wall, the posterior and anteriorperitoneum were clamped together, thus rendering the subsequentwork practically extraperitoneal. The bulging cyst was tappedand five pints of amber-colored fluid drawn off, to all appearances 196 AP MORGAN VANCE, perfectly fresh urine, leaving about one-fourth of the contentsin the sac to facilitate the enucleation. This was begun. Theseparation of the sac wall accomplished with little difficulty.I soon came to the right ureter at the bottom of the sac in thepelvis. This was cut between clamp and ligature, and theseparation continued over into the left iliac region and up theleft side of sac. To my great surprise I came upon another tube
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Fig. 4.—Case IV. running from the sac across the spinal column to the left. Iimmediately verified the existence of a left ureter, finding one ofgood size. I traced this short, thick tube to the very large leftkidney. It came away near the normal ureter. I tied it off,ligating it as near the kidney as I could, clamping the partnearer the cyst. My greatest trouble was yet to come—I meantrouble in deciding what to do, as I had fallen into new fields—anyway, new fields to me. The enucleation was continued up-ward, under the ribs, and the upi)cr part freed and brought down, ABDOMINAL CASE. 197 revealing a small kidney, about the size and shape of an Englishwalnut, with a broad, thick band of kidney tissue connectingit with the hypertrophied left kidney. I hesitated for a moment,as the blood supply of this little kidney looked so large that Ifeared it might be serving both. I had to go ahead, as backingout was out of the question. After ligating the vessels and theconnecting band with

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