A clinical lecture on dilatation of the gall bladder simulating ovarian cyst : delivered at the Samaritan Free Hospital for Women / by Alban Doran.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927.
Date:
1905
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Licence: In copyright

Credit: A clinical lecture on dilatation of the gall bladder simulating ovarian cyst : delivered at the Samaritan Free Hospital for Women / by Alban Doran. 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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    SIMULATING OVARIAN CYST. Delivered at the Samaritan Free Hospital for Women. By ALBAN DORAN, F.R.C.S., Surgeon, Samaritan Free Hospital. The relation of cholelithiasis to pregnancy and gestation is a subject of high interest which has been much investigated of late by Potocky and other French obstetricians. I have dis- cussed it elsewhere in respect to two cases under my own treatment—the first an example of old calculous obstruction of the common duct,1 the second an instance of a large bile cyst in the liver apparently traceable to a blow during gesta- tion several years before it was opened and drained.2 The gall bladder and the three ducts were unobstructed. In a third case, on which this lecture is based, a cystic abdominal tumour developed in a multiparous woman, and proved to be a gall bladder with a calculus incarcerated in the cystic duct. The relative frequency of cholelithiasis in women and its relation to gestation cannot be discussed in these notes. I shall coniine myself to the consideration of cystic gall bladder as a form of abdominal tumour in female subjects, reviewing my own experience and that of others. For dilated gall bladder, a common result of cholelithiasis, sometimes assumes characters which may cause it to be mistaken, at least on superficial inspection, for an ovarian cyst. Hence it will be instructive for us to review all reliable reports of large cystic gall bladder in women. I need not dwell on dilatation of the gall bladder in its lesser degrees, where the question of cholelithiasis and its surgical treatment is all-important, the distension of the gall bladder being a secondary matter offering no difficulties in diagnosis. This subject is amply treated in the systematic textbooks written by Osier, Waring, Rolleston, and others, and in the well-known surgical works of such authorities as Langenbuch3 and Mayo Robson.* * Dropsical gall bladder is not invariably due to cholelithiasis. Charron has described a case of dx-opsy of the gall bladder which developed after typhoid fever as a sequence of simple inflammatory disease of the cystic duct, independent of the conditions which engender cholelithiasis.