On the treatment of hydatid tumours of the liver / by John Harley.

  • Harley, John, 1833-1921.
Date:
[1883]
Catalogue details

Licence: Public Domain Mark

Credit: On the treatment of hydatid tumours of the liver / by John Harley. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    action of the bowels with deficiency of bile, progressive swel- ling of the abdomen, with increase of the pain both in degree and duration. At the end of June, 1881, she fell downstairs, and thus brought her troubles to a climax. She was admitted into Christian Ward three weeks afterwards (on 20th July, 1881), having suffered severe pain and distress in the interim. On admission her temperature was 102'8°, her expression anxious. She complained of vomiting, and of pain and swell- ing of the right side. A dry cough increased her distress, and the breathing was a little accelerated. The lower ribs of the right side were bulged forwards by a tense, dull, very obscurely fluctuating, extremely tender tumour, which invaded the right hypochondrium and epigastrium. Measurement of the side showed an increase of two inches; the lower edge of the liver corresponded to a line about one and a half above the umbilicus. There was complete dulness of the chest at the base of the right lung behind, with pneumonic crepitation and broncophony, except at the lowest part, where the breath sounds were absent. The pulse was 120. Hydatid cyst of the liver pushing up and irritating the inferior lobe of the right lung was diagnosed, and as the symptoms had become urgent a No. 12 trocar was passed into the cyst through the right hypochondrium under the rib- margin, nearly in a line with the nipple, within four hours of her admission into the hospital. A large number of cysts, some of which were moistened with pus, protruded. The canula was retained, the edge being guarded by the insertion of an elastic catheter, and for the next four days a large number of cysts were discharged with a moderate amount of sweet yellow pus, a hooked wire being occasionally used to aid their escape. On the fourth day the canula was removed over an elastic catheter previously inserted, and a second catheter (No. 3) then passed into the sac by the side of the other. As but little discharge escaped through the catheters the canula was again slipped into the sac over one of them on the day following, and much cyst evacuated. The discharge for the next few days was rather scanty, and was becoming foetid. On the eighth day, therefore, the canula being again removed over a No. 5 elastic catheter, a No. 20 elastic