Large bile cyst of the liver : jaundice without cholelithiasis : incision and drainage : recovery / by Alban Doran.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927.
Date:
[1903]
Catalogue details

Licence: In copyright

Credit: Large bile cyst of the liver : jaundice without cholelithiasis : incision and drainage : recovery / by Alban Doran. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    contained over three pints of pure olive-green *bile^ two and a half pints being removed at once and sixteen ounces a few hours later. According to Copeman and Winston olive-green is the normal colour of bile. Out of the five cases of liver cyst above related, in Mayo Robson^s alone did the cavity discharge bile, whilst when first opened the huid was clear, and there were calculi in the gall-bladder and the common duct. Jaundice.—This symptom was marked in my case, but why it appeared suddenly four months before operation I cannot explain. It began to subside when the bile flowed freely out of the drainage track after the operation, but the bile did not colour the feces until the fourth week. Thus some obstruction must have existed till that date, although the pressure of three pints of bile had been removed at the operation. The cyst probably pressed on the ducts or set up catarrh in them, as has been observed when jaundice is associated with hydatid cysts (Waring). Perhaps catarrh existed in my case, and did not subside until the fourth week ; but the three ducts looked very healthy at the operation, so that it must have been the radicles of the hepatic duct that continued to be obstructed for a while by catarrh or some other cause. The experiences of Bayer and Winckler, as well as the familiar instance of hydatid disease, show that large intra-hepatic cysts are not necessarily associated with jaundice. Hdemorrhage in jaundice.—Petechiae were very con- spicuous on the trunk. Menstruation continued quite regular during the jaundice, but the show of blood was diminished, not increased; the period appeared, with moderate show, on the second day after operation. In Cocking^s case the patient, aged 50, and jaundiced from infancy, had never suffered from haemorrhages at labour, nor at the catamenial period, which was always regular, nor after the extraction of teeth. How far the moderate doses of chloride of calcium bene- fited my patient I cannot say. I had not the least trouble