Hydatid disease of the liver : its diagnosis and treatment / by Mortimer Balding.

Date:
[1881?]
Catalogue details

Licence: Public Domain Mark

Credit: Hydatid disease of the liver : its diagnosis and treatment / by Mortimer Balding. 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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    We will next consider what happens to hydatids that are not treated by operative measures. They may undergo spontaneous cure, as is proved by finding the remains of hydatids after death in a shrivelled condition, containing hooks and portions of cyst-wall, in cases that have never been operated upon ; but as these have not generally been diagnosed or suspected during life, and are of small size, their death is probably due to some chance inflammation in or near the cyst, or to the entrance of bile, due to a communication with a bile-duct. If spontaneous cure does not take place, the cyst goes on increasing in size, pressing upon, invading, or displacing other organs, till it ruptures in one of the following directions, or causes death by pressure, viz.:— Into the pleura or lung, giving rise to pneumonia, pleurisy, or empyaema, with or without expectoration of the whole or a portion of the cyst ; and this, which is a very common course for hydatids of the liver, often ends fatally. Into the pericardium, giving rise to rapidly fatal pericar- ditis. Into the peritoneum, causing peritonitis, which, if the cyst is large, is generally rapidly fatal; the immediate cause of the rupture being generally an accident. Through the abdominal parietes or intercostal spaces ; but this is rather rare, especially in small cysts, so that by the time this takes place the cyst is of large size, and, as it of necessity takes on suppuration, it is very likely to exhaust the patient. Into the stomach or intestine. Under these circumstances, the contents of the cyst are generally passed per rectum ; this is the most favourable course the disease takes. In a case under my care some time ago, a patient who had been suffer- ing for some time from a large fluctuating tumour in the region of the liver, supposed to be hydatid, and who refused all operative measures, v/as seized during the night with severe pains in the abdomen, and the next mowing passed what was described to me as a large quantity of matter, containing what looked like grape-skins ; this was accompanied by a