. Annals of surgery . end of the commonduct above the stricture, andthe common duct end wassutured to the duodenum byfour fine silk sutures. A drainwas inserted to the bottom ofthe wound and removed on theseventh day. The patient wasdischarged on December 30th. Tube passed the 27th day. C.\SE IV.—Mrs. M., December 30, 1912. aged twenty-nine, married. Thepatient was operated on ten months ago for gall-bladder disease; then again sixweeks later. For four months there were intermittent jaundice, pain, and vomit-ing, and the stools were clay-colored. Stricture of the common duct was foundand opene
. Annals of surgery . end of the commonduct above the stricture, andthe common duct end wassutured to the duodenum byfour fine silk sutures. A drainwas inserted to the bottom ofthe wound and removed on theseventh day. The patient wasdischarged on December 30th. Tube passed the 27th day. C.\SE IV.—Mrs. M., December 30, 1912. aged twenty-nine, married. Thepatient was operated on ten months ago for gall-bladder disease; then again sixweeks later. For four months there were intermittent jaundice, pain, and vomit-ing, and the stools were clay-colored. Stricture of the common duct was foundand opened. A tube was inserted with the cuff turned back for the proximal end;the other end was carried down into the duodenum; the duct was sutured over it;the wound was closed with drainage. Recovery was prompt, with relief of symp-toms. The tube passed in nine weeks. V.—Patient aged thirty, married, two children. There was frank gall-stone disease, associated with occasional jaundice. No previous operations. 13fi. Fig. 7.—Illustrates a new id to diagnosis of natureof obstruction in common duct. If the patient be studiedfluoroscopically by lateral view during the passage ofbarium through the duodenum, it is many times possiblefor the rontgenologist, by massaging the duodenum, tomake the barium enter the lower end of the commonduct; if stone be present, to so coat the stone with bariumthat it will then show for many days in an X-ray stone endeavoring to escape from the common duct isprobably preceded by a relaxation of the distal end of theduct, similar to the softening and relaxation that occursin the uterine cervix with the descending head of would ask the members in their future cases of suspectedcommon duct stone obstruction, to test out this observa-tion, as I believe they will have frequent gratifying con-firmation of their suspicions. Emphasis must be laid uponthe need of lateral observation of the patient, becausethe common duct enters into the du
Size: 1569px × 1593px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
