Adenocarcinoma of Small Intestine in Father and Daughter

secretion.It is true that several cases have been reported in which unilateral infected nephrolithiasis has caused a general rise of blood pressure.It probably acts by effecting a chemical constriction of all arterioles, including efferent glomerular arterioles but excluding afferent arterioles (Pickering, 1943).Thus the glomerular pressure in the sound kidney should rise and, if anything, more urea should be excreted, because urea is probably secreted by a process of mechanical glomerular filtration and not by tubular secretion.In this patient another unknown mechanism -must have been involved, because there was no general rise of blood pressure and there was lessened urea excretion as judged by his raised blood urea.Summary A mobile renal calculus, according to its different positions, so changed the clinical picture that the following conditions were successively diagnosed: appendicitis, gall-stones, renal calculus, malaria.During the phase of infected early hydronephrosis the opposite healthy kidney was affected; no explanation has been found for this.A method is described for accurately locating the stone at operation.Thus only a small incision in the renal substance was needed; this minimized the risk of gross post-operative haemorrhage.