Talma operation for cirrhosis of the liver : with report of cases / by Edgar A. Vander Veer.

  • Vander Veer, Edgar A., 1873-1953.
Date:
1912
Catalogue details

Licence: In copyright

Credit: Talma operation for cirrhosis of the liver : with report of cases / by Edgar A. Vander Veer. 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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    Dr. Macdonald and other associates, but the pathology being so little understood, there seemed to be somewhat of a reluctance on the part of operators to do the operation.” Case III.—Mr. B. L., aged twenty-nine years, born in United States, commercial traveller. He entered the service of Dr. James F. Rooney at the Albany Hospital on March 7, 1911, suffering from ascites. He first noticed this condition some sLx months previous, when he had been tapped and a large amount of fluid removed. The ascites returned at the end of two months, when he was again tapped and about the same amount of fluid remov^ed. The ascites returned once more, and until two weeks before he entered the hospital, he had been tapped about every third day. Upon entering the hospital he had the appearance of a pale, emaciated man, with a protuberant abdomen. Physical examina- tion negative, with the exception of a markedly atrophied liver. Past history negative; no alcoholic or syphilitic history obtainable. Patient kept on medical treatment for three weeks and seemed to gain strength. Operation was performed on March 31,1911. A median incision between the umbilicus and symphysis pubis was made. Upon opening the abdomen there escaped a large amount of straw- colored fluid. Examination of the peritoneal cavity, through the incision, showed a markedly hobnailed condition of the hver. Omentum brought into the incision and as much as possible of the surface of the omentum sutured to the anterior abdominal wall. Rubber drainage tube inserted in the lower angle of the incision and the wound closed with silkworm-gut sutures. The patient was slow in recovering from the shock of the opera- tion, but gradually regained his strength. The drainage tube was left in position for ten days and during that time a large amount of fluid escaped. Just how much I am unable to say, as it drained into the dressings, which were changed every few hours for the first few days following the operation. He was discharged from the hospital May 12, 1911, fully recovered and able to return to his work by the first of July, and at the present time has practically regained his former good health;