. A manual of operative surgery . ial thing during the operation is to remove the endocyst. The fibrous layer outside this is quite harmless, and a futile attempt to dissect it out from such a vascular organ as the liver would certainly be attended by dangerous haemorrhage. The fingers or a broad sponge-holder serve best for grasping the membrane, which can often be thus twisted or folded on itself so as to facilitate its removal. The treatment outlined above is, as a rule, the only satis-factory one for hydatid disease, whether of liver, lung, or otherviscus. It is of interest to note that oc
. A manual of operative surgery . ial thing during the operation is to remove the endocyst. The fibrous layer outside this is quite harmless, and a futile attempt to dissect it out from such a vascular organ as the liver would certainly be attended by dangerous haemorrhage. The fingers or a broad sponge-holder serve best for grasping the membrane, which can often be thus twisted or folded on itself so as to facilitate its removal. The treatment outlined above is, as a rule, the only satis-factory one for hydatid disease, whether of liver, lung, or otherviscus. It is of interest to note that occasionally a hydatid cystprojects from the liver, to which it is only joined by a narrowpedicle. This is shown in Fig. 41, and we have operated onJ 130 ABDOMINAL OPERATIONS [PART II another similar case. Here, of course, the surgeon has a very-easy task: the whole cyst is excised by division of the pedicle,care being taken to stop all haemorrhage afterwards by pressureand by the insertion of one or two deep catgut sutures through. FIG. 41.—LARGE HYDATID CYST EXCISED WITH ATTACHED PEDICLE OF LIVER OF ALL SIZES ARE SEEN WITHIN THE PARENT ONE. (London Hospital Museum.) the liver edge. By making a V incision the liver can beneatly sutured so as to leave no raw surface. Sometimes, besides the main cyst operated on, there may be anumber of others disseminated through the same or other occurred in one case of hydatid of the lung operated on at theLondon Hospital—one main cyst with daughter ones was removedafter partial excision of ribs, etc. The patient died, and upwardsof a hundred small cysts were found scattered through bothlungs. chap, ii] HYDATIDS OF THE LIVER 131 Aspiration or galvano-puncture as a curative measureshould not be resorted to. Even when used for the purposeof diagnosis, aspiration is not without risk, unless the tumourhas already been exposed and the surgeon can at once proceedto removal of the cyst. Amongst the accidents that
Size: 1439px × 1736px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, booksub, booksubjectsurgicalproceduresoperative
