Keen has reported four instances of accidental injury to the
thoracic duct, near its termination at the base of the left side
of the neck; the wounding was in the course of removals for
deep-seated growths in this region. Three of the cases recovered,
having sustained no detriment from the injury to the thoracic
duct. One died; but the fatal influence was not specially
connected with the wound of the duct.
Possibly the boldest operation in the history of surgery is that
for ligation of the abdominal aorta for inguinal aneurysm. It was
first practiced by Sir Astley Cooper in 1817, and has since been
performed several times with a uniformly fatal result, although
Monteiro's patient survived until the tenth day, and there is a
record in which ligature of the abdominal aorta did not cause
death until the eleventh day. Loreta of Bologna is accredited
with operating on December 18, 1885, for the relief of a sailor
who was suffering from an abdominal aneurysm caused by a blow. An
incision was made from the ensiform cartilage to the umbilicus,
the aneurysm exposed, and its cavity filled up with two meters of
silver-plated wire. Twenty days after no evidence of pulsation
remained in the sac, and three months later the sailor was well
and able to resume his duties.
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