. Diseases of the gall-bladder and bile-ducts, including gall-stones . internally bythe peritoneum covering the spine—has been long recog-nised, but perhaps not sufficiently appreciated in gall-bladdersurgery. Mr. Rutherford Morison drew attention to it in a paper inthe British Medical Journal for March 3, 1894. It is possible to drain this pouch satisfactorily by means ofa long glass tube, but it is probably safer on the whole tomake use of a lumbar drain. The author referred to places 22 DISEASES OF THE GALL-BLADDER AND BILE-DUCTS such reliance on the ease and safety with which it can bedrai
. Diseases of the gall-bladder and bile-ducts, including gall-stones . internally bythe peritoneum covering the spine—has been long recog-nised, but perhaps not sufficiently appreciated in gall-bladdersurgery. Mr. Rutherford Morison drew attention to it in a paper inthe British Medical Journal for March 3, 1894. It is possible to drain this pouch satisfactorily by means ofa long glass tube, but it is probably safer on the whole tomake use of a lumbar drain. The author referred to places 22 DISEASES OF THE GALL-BLADDER AND BILE-DUCTS such reliance on the ease and safety with which it can bedrained that he does not advocate much time being spentin suturing incisions in the gall-bladder or bile-ducts. It isinteresting to note that it is capable of holding nearly a pintof fluid before it overflows into the general peritoneal cavity,through the foramen of Winslow or over the pelvic brim. A deformity of the liver, congenital or acquired, may attimes lead to a difficulty in diagnosis or in treatment. Thecommon form is a tongue-shaped prolongation of the right. Fig. 8.—Linguiform Process of Liver. lobe, which may project below the costal margin for severalinches and simulate a tumour of the liver or an enlargedgall-bladder. One form of the enlargement shown in Cruveilhiers Atlasis supposed to have been due to tight-lacing; it wasassociated with dropsy of the gall-bladder and gall-stones. In some instances the gall-bladder projects beyond theapex of the linguiform projection, as in a case described byDr. Hellier* (Fig. 8). In Case 234 the gall-bladder and linguiform process of theliver reached the caecal region, and the recurrent attacks of * British Medical Journal^ May 4, 1895. ANATOMICAL CONSIDERATIONS pain associated with local peritonitis and unaccompanied byjaundice much resembled recurring appendicitis, the point ofgreatest tenderness being situated midway between theumbilicus and anterior superior spine of the ilium, in whichposition the incision for the operatio
Size: 1571px × 1591px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, bookpublishernewyorkwilliamwood
