THE PROBLEM OF MALIGNANT HYPERTENSION AND ITS TREATMENT BY SPLANCHNIC RESECTION

Abstract

A study was made of 143 cases of malignant hypertension, each treated by the operation of bilateral resection of the greater, lesser, and least splanchnic nerves, and excision of the 8th, 9th, 10th, 11th, and 12th thoracic sympathetic ganglia. The 5-yr. survival rate for the series was 21.6%. This finding suggests that surgical treatment offers some hope to victims of this disease, which usually has been rapidly fatal when treated otherwise. Improvement in the ecg. and decrease in heart size are possible in those cases who survive 5 yrs. or more. Once kidney function becomes moderately or markedly impaired, splanchnic resection is futile; no case with azotemia survived 2 yrs.