Clinical papers / by J. Halliday Croom.

  • Croom J. Halliday (John Halliday), Sir, 1847-1923.
Date:
1901
Catalogue details

Licence: In copyright

Credit: Clinical papers / by J. Halliday Croom. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    becomes stretched and the tumour tense, so that the move- ment of the intestines and al)dominal walls causes it to rotate on its own axis. It is only by some recurring cause such as this that ten or twelve twists can be accounted for. Any accident or strain may cause one, but the difficulty is to explain the repeated twist. In the two cases 1 refer to, the tumours were known to exist in the pelvis previous to the occurrence of the twist, and in botli cases the patients were conscious of rapid abdominal enlargement. It seems likely that the tilling and emptying of the bladder, giving rise to increased or diminished abdominal pressure, may play a more active part in the production of these repeated twists tlian the rectum. 2. The next case of interest is one of cholecvstotomv. The V %f patient, a married woman, let. 45, was sent to me by Dr. ]\lacleod of Hawick as suffering from all stones. Slie was sufferiiig }>ain over her liver, and had repeated attacks of jaundice. I could feel no swelling over the border of the liver, only an ol)scure tenderness. As her attacks of jaundice were frerpient, however, and tlie tenderness over the liver, though slight, yet continued well marked, I arrived at tlie same conclusion as Dr. Macleod, that she was sutferiii from all stone. The ordiuaiy incision was therefore made in the side, and with some difficulty tlie median fissure of the liver was readied, and the small slirunken gall bladder with difficulty recognised. It was not bigger than a filbert, and was firmly contracted round the gall stones. It was drawn with difficulty to the surface and incised, and two gall stones were extracted. 'The gall bladder was sewn to the abdominal wall, and the fistula treated in the ordinary way. The ojieration was a long, tedious, and difficult one, lasting over an hour and a half. '^1 he patient was well that night and the followiii dav, but died suddenly with obscure symptoms, and as no post- mortem was allowed, I cannot give any definite explanation of the untoward result.
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