CASE HISTORY

Patient had suffered from tubercular hip disease for many years. For eight months before admission she began to suffer from dysuria. At this time she was investigated at the hospital and tubercle bacilli were found in the urine. Since this time she had some pain in the left loin and in the suprapubic region. On cystoscopy the left ureteric orifice and the surrounding bladder mucous membrane were red and oedematous but no tubercles were seen. A nephrectomy was performed, the ureter being injected with pure carbolic acid before being cut, and the distal cut end being brought out into the wound. After operation the wound healed well though the ureter remained unclosed for some time. Later she developed a slight herniation in the scar. Whilst in hospital she also developed a sinus in her hip, but this cleared up. On discharge she was considerably improved though still suffering from some frequency.

PATHOLOGY

Kidney 155mmx165mmx50mm. The kidney has been split and the two halves mounted together. On the outer surface (back of specimen) there are a number of slightly raised, whiter areas, some of which shows a little haemorrhage. On the cut surface these areas are confined to the cortex and show a little irregular haemorrhage. They are mostly of about the same colour as the surrounding kidney but they show odd white points. The pelvis, calyces and tips of the pyramids are all of dead white colour and appear necrotic. This is an artefact due to the injection of phenol during the operation.