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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    catheter was easily introduced by its side, and then by means of a fine-nozzled 4-oz. brass syringe, cyst-membrane was readily drawn through the wide eye of this large catheter, aspiration being sustained during the act and quantities of very large and thick cyst-membrane were drawn out of the wound every time the catheter was withdrawn. As the catheter could be readily passed by the side of the guiding one into the cyst this process was kept up for about three hours, and until nearly a quart of hydatid cyst, moistened with foetid pus, was removed; an ounce or two of carbolic-acid water (1 to 20) was then injected and removed, the process being repeated until about a quart had been used and the fluid came away clear. The cyst being thus fairly emptied very great relief was experienced, and by daily repetition of the process for the next two days about as much more cyst-membrane, some very large, was removed, and this was accompanied by a discharge of yellow bile. The cyst was now completely emptied, and for the next three weeks it was daily washed out with carbolic-acid water, and then, as there was some evidence of carbolic-acid poisoning, with a weak solution of chlorinated soda, the fluid readily flowing from one catheter as it was injected by the other. On the thirty-eighth day the catheter passed a distance of eight inches, and the cyst held about five ounces of fluid without discomfort. Fifteen days later the cyst was reduced to half its size, the discharge was normal pus and small in quantity. The larger tube was alone retained and shortened from time to time as the cyst contracted. On the seventieth day after the primary insertion of the canula, the sinus had quite healed and the surrounding abdomen and rib margin was normal and bore deep pressure without inconvenience, resonant below, and normal liver dulness above. She was discharged quite well on the eighty-eighth day. On admission there were signs of pneumonia, but as the cyst was a large one and pushed the diaphragm upwards, it was not possible to accurately determine the amount. All her symptoms were relieved by the evacuation of the contents of the cyst, the temperature becoming normal except occasionally in the evening when it twice or thrice rose to 101°. On the