Gall-stones and diseases of the bile-ducts . Fig. 27.—Gall-bladder with gall-stone impacted in the cysticduct. The small body on the gall-bladder is an accessoryliver. gall-bladder. In normal conditions the cystic ductmeasures in transverse diameter 3 mm., and itslumen is irregularly encroached upon by the foldof its mucous membrane, known as the valves ofHeister. No very accurate statements can be made GALL-STONES IN CYSTIC DUCT 71 in regard to the size of concretions which are ableto pass along this duct, and I have, on several. fife **, ^e. AU *«* Vo/tfl ,[c Fig. 28.—Gall-stones from the ne
Gall-stones and diseases of the bile-ducts . Fig. 27.—Gall-bladder with gall-stone impacted in the cysticduct. The small body on the gall-bladder is an accessoryliver. gall-bladder. In normal conditions the cystic ductmeasures in transverse diameter 3 mm., and itslumen is irregularly encroached upon by the foldof its mucous membrane, known as the valves ofHeister. No very accurate statements can be made GALL-STONES IN CYSTIC DUCT 71 in regard to the size of concretions which are ableto pass along this duct, and I have, on several. fife **, ^e. AU *«* Vo/tfl ,[c Fig. 28.—Gall-stones from the neck of the gall-bladder and thecystic dnct. These calculi found their way into the intestine,and were voided with the faeces. (Middlesex Hospital.) occasions, found it absolutely obstructed by acalculus the size of a cherry-stone. There is a very characteristic form of gall-stonewhich is found in a very dilated cystic duct; it 72 DISEASES OF THE BILE-DUCTS occurs in sets of three; the middle one is facettedat each end, which causes it to resemble a large calculi are always bile-stained, whichserves to show that though big and situated in awidely-dilated duct they probably allow a smallamount of bile to trickle past them; and this mayalso account for their size, for if the duct will notadmit anything exceeding the dimensions of acherry-stone, it is certain that calculi as big ascherries could not enter it. The inference is obviousthat small calculi find their way into the duct andgradually increase in size
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