Southern medicine and surgery [serial] . g closed. This is 518 SOUTHERN MEDICINE AND SURGERY December, 1924. what had happened in this case: Therehad been an acute cholecystitis whilethis stone occupied the gall bladder; ad-hesions had formed between the gallbladder and a loop of the intestine justbeyond the jejunum; necrosis had oc-curred from the pressure of the pointedend of the stone allowing it to passthrough the gut. This was verified byexploration. The union which had oc-curred between the gall bladder and gutwas surrounded by a mass of well or-ganized fibrous tissue. The size of thesto
Southern medicine and surgery [serial] . g closed. This is 518 SOUTHERN MEDICINE AND SURGERY December, 1924. what had happened in this case: Therehad been an acute cholecystitis whilethis stone occupied the gall bladder; ad-hesions had formed between the gallbladder and a loop of the intestine justbeyond the jejunum; necrosis had oc-curred from the pressure of the pointedend of the stone allowing it to passthrough the gut. This was verified byexploration. The union which had oc-curred between the gall bladder and gutwas surrounded by a mass of well or-ganized fibrous tissue. The size of thestone prevented its unobstructed pas-sage through into the colon. Thiscaused an obstruction which was reliev-ed by dilatation of the intestinal wallimmediately surrounding the obstruction would occur whichwould in five or six days be would give relief and for somecause the stone would be again presseddown into the smaller gut. This hadbeen repeated four times with recoveryfollowing and the chances are about even. Preparatory to removing the gall-bladder, aligature has been placed around the cystic ductwhere it joins the common duct. that relief would have been broughtabout again had the operation not beenresorted to. One of our recent patientswas admitted in a desperate condition,suffering great pain. One grain of mor-phine was given without obtaining en-tire relief but chloroform had been givenwhile in transit to the hospital. He wasoperated upon immediately. There wasfound a tremendously distended gall bladder containing fluid mixed with pusand four rough stones the size of a mul-berry. A smaller stone could be felt inthe common duct which could not bemilked back into the gall bladder. Thiswas crushed and removed by the gallstone forceps. The swollen conditionin the region where the ducts enteredthe intestine led us to refrain from re-moving the gall bladder. We were surethat there was nothing passing throughthe duct. The patent was very jaun-diced. H
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectmedicine, bookyear192
