. Diseases of the gall-bladder and bile-ducts, including gall-stones . mmon bile-duct, aportion of it projecting into the duodenum. There was alarge hydatid cyst in the right lobe of the liver. It was takenfrom a boy, aged fourteen, who died from jaundice, accom-panied by pain, fever, and delirium. Three months beforedeath he was said to have hepatitis (Fig. n). No. 1,384, Guys Museum, shows a hydatid cyst openinginto the hepatic duct, a piece of hydatid membrane project-ing through the papilla into the duodenum. The ductsthroughout the liver are dilated and filled with pus. Itoccurred in a ma
. Diseases of the gall-bladder and bile-ducts, including gall-stones . mmon bile-duct, aportion of it projecting into the duodenum. There was alarge hydatid cyst in the right lobe of the liver. It was takenfrom a boy, aged fourteen, who died from jaundice, accom-panied by pain, fever, and delirium. Three months beforedeath he was said to have hepatitis (Fig. n). No. 1,384, Guys Museum, shows a hydatid cyst openinginto the hepatic duct, a piece of hydatid membrane project-ing through the papilla into the duodenum. The ductsthroughout the liver are dilated and filled with pus. Itoccurred in a man of fifty, who had jaundice a month beforeadmission, and died a week after. No. 196A, St. Georges Museum, and No. 1,582, MiddlesexMuseum, are also examples. 54 DISEASES OF THE GALL-BLADDER AND BILE-DUCTS Case 161 is an example of successful operation for infectivecholangitis dependent on hydatid disease. Mr. Jonathan Hutchinson junior operated on a youngwoman suffering from intense paroxysmal pain with hightemperature and sickness, in whom the gall-bladder could be. Fig. ii. — Hydatid, rolled upand blocking common blle-duct, Portion projecting intoDuodenum. Taken from a boy of fourteen, whohad a large hydatid cyst in rightlobe of liver. Death from sup-purative cholangitis. (No. 2,252,St. Bartholomews Museum.) Fig. 12. — Infective Cholangitis,showing Dilated Intra-hepaticDucts. Cause—cancer of ampulla of Vater.(No. i,307A, St. Thomass Museum.) felt; it was very tense. Cholecystotomy was performed,and numerous hydatids let out. An opening could be feltbetween the cyst in the liver and the gall-bladder. Pusescaped with the bile for a time, but the patient is nowwell. INFLAMMATORY AFFECTIONS 55 Ascarides in the Bile-ducts.—Mertens has collected* forty-eight cases in which ascarides have been found in thebile-ducts. In only five cases were there symptoms point-ing to the presence of gall - stones, and in two only wasthe cause of the symptoms determined during life. Mertensp
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