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The so-called false or acquired diverticula of the small intestine have been of very little interest to clinicians because of their supposed rare occurrence and also because it was thought that they rarely or never give rise to any clinical symptoms. The following case with multiple mesenteric diverticula of the small intestine shows that, apparently, even in these heretofore considered benign diverticula inflammatory changes may occur which may give rise to clinical symptoms and even endanger the life of the individual. In this case, apparently, one of the diverticula became inflamed and a diverticulitis occurred, causing a partial obliteration of the diverticulum. As the diverticulum extended between the folds of the mesentery, the later became inflamed, thickened and puckered, thus causing an angular bending of the intestine and obstructing its lumen. The local peritonitis arising as the result of this gave rise to the formation of adhesions between the mesentery

Now that visualization of the urinary tract by intravenous medication is possible, there is sure to be an increasing demand for urograms. Therefore, the radiologist should beware of faulty reasoning from effect to cause. This error is never made in diagnosis with greater danger than in the case of the patient with unexplained abdominal symptoms, who is found to have a kinked or angulated ureter. The presence of acute angulation of the ureter in one who complains bitterly of pain that is referred apparently from the ureter presents such a likelihood of relationship between cause and effect that it is difficult for the clinician, and sometimes impossible for the surgeon, not to fall into this trap. When a patient returns several months after operation, the previous symptoms persisting, it becomes evident that kinks of the ureter occasionally occur in the presence of pathologic changes elsewhere. The kidney and the ureter are held in position by entirely different supports. The ureter, which is attached to t...

Each year, in the urologic section of the Mayo Clinic, more patients are seen than in the year before who state that they have been informed that a kink in one of their ureters is responsible for their rather indefinite symptoms and that its surgical correction is urgent. On general examination, evidence of renal ptosis is not demonstrable and pyelograms fail to show the kink previously pointed out to the patient. This discrepancy has occurred so often that we recently reviewed our old pyelograms in order to ascertain the frequency of ureteral kinks. We were astonished to find how frequently a kink would be present in one roentgenogram but absent in a subsequent exposure, although the identical portion of the ureter might have been exposed but a few minutes later. The literature contains several articles calling attention to the part that a ureteral kink may play in the production of

Excerpt Tumors involving the white matter of the parietal lobe are not common, and relatively rare are those of an infiltrating type that involve by direct pressure or actual destruction the sensor...

The possibility that renal tuberculosis, once it has reached the point at which diagnosis is beyond question, ever heals has received considerable discussion during the last fifteen years. In 1920 Chute1reviewed three cases that occurred in his practice; he considered that there were indications in occasional cases that tuberculous processes of the kidney healed. He pointed out how such a belief is necessary if one is to accept the hypothesis of the hematogenous route of the infection. He says: I believe we must assume that tubercle bacilli are brought in approximately equal numbers to both kidneys, that small cortical tuberculous infections are common and that far from going on to complete destruction of every kidney that is infected they are probably promptly stamped out in the greater majority of instances. The generous blood supply of the kidney allows it to overcome perhaps the greater number of infections while

It is generally recognized that the removal of urine from a chronically overdistended bladder is often followed by untoward symptoms, or death. If the bladder is emptied rapidly and completely at one time, the sudden reduction of the intravesical pressure results in immediate congestion throughout the urinary tract, with resulting edema and hemorrhage, which may be so severe as completely to suppress renal function by increasing the pressure within the renal capsule to a point incompatible with glomerular and tubular function. Even though the process may not go on to complete suppression of urine, the congestion and edema make the urinary tract a fertile field for infection, a complication which is borne very poorly by this class of patients, and is the undoubted cause of many of the fatalities. O'Conor 1 has shown that, coincident with emptying the bladder of residual urine, there is a decided fall in blood pressure.