Hematuria : a study from the practitioner's standpoint / by Victor Cox Pedersen.

  • Pedersen, Victor Cox, 1867-1958.
Date:
1913
Catalogue details

Licence: In copyright

Credit: Hematuria : a study from the practitioner's standpoint / by Victor Cox Pedersen. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    changes in the urine from which the stone orig- inally arose. Thus it is sometimes possible from these crystals to suggest the character of the stone. The diagnosis of the hematuria of renal lithiasis rests materially on radiography, which should never be omitted in doubtful cases, is advisable in all cases, and in expert hands rarely fails to give some result except in pure uric acid stones, and even in these, changes in the kidney shadow may be highly important. The choice of operation for these cases is the period before infection sets in, hence the im- portance of early and thorough going diagnosis. When the results of radiography are not con- sonant with clinical and cystoscopic indications, it is best to have another sitting. I recently reported a case of lithiasis of nearly two years’ duration in which a first x ray examination was negative, while a second and third were positive and more and more conclusive of stones in the kidney, ureter, and bladder. Renal tuberculosis with hematuria is being recog- nized more and more frequently through improved procedures in diagnosis. Bleeding may be an early and prominent symptom or appear after the estab- lishment of pyuria, which is rather commonly the fact. The lesion, like tuberculosis elsewhere in the body, has little respect for age, but rather favors the earlier than later half of life. In quantity the blood is small and intermittent with long or short periods of absence, or copious and persistent with little or no remission. Either or both kidneys may be affected and are congested, palpable, and tender, and show more or less discomfort and pain, rather constant with exacerbations, especially after pyuria appears and during actual bleeding. The tubercles are usually in the walls of the pelvis of the ureter or on the surface of the papillae of the kidney, pro- jecting into it so that ulceration in eroding blood- vessels produces bleeding directly into the ureter with little or no signs of blood casts from the