. Diseases of the gall-bladder and bile-ducts, including gall-stones . h-J. 5 ffl Ph - TUMOURS OF THE GALL-BLADDER AND BILE-DUCTS 125 Where the gall-bladder becomes attached to any hollowviscus a fistula is apt to form (see p. 80). The disease may spread along the mucous membrane andaffect the ducts, and give rise to obstructive symptoms. At times, though rarely, the peritoneum becomes infected,and there then rapidly follows ascites, and obstruction of theveins of the lower extremities. The lymph glands at the hilum are usually affected, butsystemic infection is rare. The very frequent associa
. Diseases of the gall-bladder and bile-ducts, including gall-stones . h-J. 5 ffl Ph - TUMOURS OF THE GALL-BLADDER AND BILE-DUCTS 125 Where the gall-bladder becomes attached to any hollowviscus a fistula is apt to form (see p. 80). The disease may spread along the mucous membrane andaffect the ducts, and give rise to obstructive symptoms. At times, though rarely, the peritoneum becomes infected,and there then rapidly follows ascites, and obstruction of theveins of the lower extremities. The lymph glands at the hilum are usually affected, butsystemic infection is rare. The very frequent association of cancer of the gall-bladderwith gall-stones is an undoubted fact, and in all probabilitythere is a connection between the two diseases. Zenker* found gall-stones in 85 per cent, of cancers of thegall-bladder, and Musser, from an analysis of 100 cases, givesthe proportion associated with gall-stones as 69 per cent.,which may, however, be an under-estimate, as it is wellknown that gall-stones may produce serious irritation, andthen pass into the alimentary canal, so
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