An Unusual Foreign Object in the Kidney

Abstract

ALL roentgenologists in contact with a large turnover of patients encounter rare lesions of various kinds and unusual situations. This paper covers one such case which appears so out of the ordinary and presents a phase seemingly so unexplainable that it seems worthy of a report in detail. A patient of Dr. William Miller of the Surgical Staff of Wesley Memorial Hospital, Mrs. C. D., aged 42, white, weighing 125 pounds, a native of the United States, came to the hospital in August, 1927, complaining of weakness, loss of weight, energy, and appetite. Four months prior to entrance she noticed a tender lump in her left side. She had lost ten pounds in weight during the previous two weeks. Three months before she had suffered attacks of abdominal pains, sharp in character, which occurred a few minutes after eating and lasted for about fifteen minutes. These pains came on intermittently and did not occur daily. Each attack was followed by a period of diarrhea. No relationship to any particular food was noted. She had the feeling of being bloated or distended with gas. One week before entrance to the hospital she suffered a particularly severe attack of pain in the pit of the stomach, which was followed by nausea and vomiting. She complained of a lump in her left side which she had first noticed four months before, at the time she began to lose weight. She had had occasional attacks of left-sided pains since childhood. Ten years before admission she had had lumbar pain and pyuria, at which time she was told by Dr. V. C. Lespinasse, attending urologist of Wesley Memorial Hospital, that she had a left-sided pyonephrosis. After that attack she seemed to get better and did nothing for this condition, remaining in fairly good health for the intervening years until the recent trouble. She had had five children, three of whom were living and well, and she admitted many self-induced abortions, the last one two years previous, from which she said she had never fully recovered. She had been curetted once but had had no abdominal operations of any kind. She related that ever since childhood she had been bothered by a recurring sharp stitch in her left side. On physical examination, tenderness over the gall-bladder region was elicited and a tumor mass was palpated in the left side of the abdomen. This was thought at first to be an enlarged spleen. The liver was enlarged, its lower edge being three fingers' breadth below the costal margin. The stomach was distended with gas. A blood examination showed 3,700,000 red cells, 14,600 white cells, and 59 per cent hemoglobin. A negative Wassermann was reported. The urinary findings included the presence of albumin, pus, and blood cells. X-Ray Phases Because of the nausea and vomiting and pain occurring immediately after eating, the patient was referred for an X-ray study of the digestive tract.