A case of hydatid cyst of the liver : serious displacement of viscera, operation, death / by R. Lawford Knaggs.

  • Knaggs, Robert Lawford.
Date:
[1890]
Catalogue details

Licence: Public Domain Mark

Credit: A case of hydatid cyst of the liver : serious displacement of viscera, operation, death / by R. Lawford Knaggs. 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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    Reprinted from Vol. XXI11 of the ' Clinical Society’s Transactions.’’} A case of Hydatid Cyst of the Liver: serious dis- placement of viscera: operation: death. By R. Lawford Knaggs. Bead April 11, 1890. HANNAH S., ast. 3G, who was sent to see my father by Dr. Carter, of Raistrick, camo under his care in the Hudders- field Infirmary. Two years ago she first noticed a lump in the stomach, which had gradually increased. It had caused her no inconvenience except shortness of breath on exertion. She had had two severe attacks of obstructive jaundice. There were numerous and large varicose veins upon both legs, which began to appear about six years ago. The legs swelled after walking, but they had not been worse since tho lump became more prominent. She suffered neither from cough nor from palpitations. There was a large, tense, globular swelling presenting at tho opigastrium, and raising that part with the lower portion of the ensiform cartilage into a rounded eminence, thus giving the patient a peculiar appearance. The whole thorax was pushed up, making her look short-necked and high-chested. The swelling contained fluid, and a thrill could be felt from the epigastrium to the lower ribs on each side behind, and into each loin, but more readily on the right sido. The liver dulness extended in front from the level of the third costal cartilage to tho right anterior superior iliac spine. The upper limit of dulness was horizontal until it blended with tho cardiac dulness over the loft apex, but below, tho line ex- tended obliquely from the anterior superior spine upwards and across the abdomen to the left costal margin. A notch was felt in tho liver at the umbilicus, and on the right side of this notch a thick rounded liver edge could be traced till it disappeai’ed behind the iliac crest, close to the anterior superior spine. On the left side the rounded under- surface of a cystic tumour, as large as an ordinary gas globe, could easily be felt. The liver moved slightly with respira- tion. The cardiac dulness occupied the first and second costal spaces on the left side, and blended below with the liver dul- ness ; there was visible pulsation over this area, and there was a distiuct impact from the closure of some of the valves. The