Traumatic rupture of the gall-bladder without injury of the liver : sixty-four ounces of bile in the abdominal cavity, recovery / by De Forest Willard.

  • Willard, De Forest, 1846-1910.
Date:
1902
Catalogue details

Licence: In copyright

Credit: Traumatic rupture of the gall-bladder without injury of the liver : sixty-four ounces of bile in the abdominal cavity, recovery / by De Forest Willard. 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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    appetite returned, and sleep, which had been greatly interfered with, became normal. The fluid slowly reaccumulated, however, and during my absence from the city he was aspirated two weeks later, thirty-two ounces of bile being withdrawn. Fol- lowing this, the reaccumulation of fluid was so slow, and the improvement in general condition so marked, that I decided to await developments rather than to operate, especially as the stools showed bili- ary secretions that were nearly normal and diges- tion and assimilation were excellent.' Head exten- sion and dorsal rest were enforced, to control the traumatic spondylitis. Four weeks later a protru- sion appeared at the line of the wound; this was opened aseptically and about two ounces of bile flowed from the opening. A long rubber tube was then carried upward to the site of the gall-bladder, and withdrawn slowly at each dressing. The flow of bile diminished daily and ceased entirely two months and a half after the first operation. The sinus slowly closed with stimulation by curetting, mopping with tincture of iodine, etc., until the final closure was secured six months after the first in- cision. A spinal support was adjusted three months after the first operation, and the child ran and played throughout the remainder of the convales- cence without pain or discomfort. The stools were perfectly normal, and nutrition was perfect. At the present writing he is apparently in perfect health. Rupture of the gall-bladder alone is exceedingly rare. It is difficult to explain how it could occur from a wheel injury such as was sustained by this boy without a rupture of the substance of the Jiver or some other organ. It is hardly probable that he had any gall-stones in the bladder, as he had had no previous difficulty, and there was no probability of its having been tensely distended. Since he recov-