Large bile cyst of the liver : jaundice without cholelithiasis : incision and drainage, recovery / by Alban Doran.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927.
Date:
1904
Catalogue details

Licence: In copyright

Credit: Large bile cyst of the liver : jaundice without cholelithiasis : incision and drainage, recovery / 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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    There was no jaundice. The cyst was exposed by an exploratory incision, and eight litres of a glairy yellow fluid were removed. This fluid was highly albuminous, and contained a trace of bile according to Gmelin’s test. The cyst wall was of pure connective tissue, from one to two millimetres in thickness, without either glands in its substance or epithelium on its inner surface. The cyst was drained and convalescence was somewhat protracted. North reports a case where the cause of obstruction was detected after death. The patient was a man aged 45, subject to chronic jaundice. A cystic swelling in the hepatic region was tapped, and five pints of a coffee- coloured fluid were drawn off. The patient died on the second day. A unilocular cyst as big as a man’s head was found closely connected with the left lobe of the liver. A calculus of the size of a marble was found im- pacted in the common duct, and there was a large stone in the gall-bladder. We may agree with Waring that the cavity containing bile in this case must be ranked as a retention cyst, but he notes that the nature of the con- tents was not made clear. The fifth case was reported by Mayo Robson. The patient was a woman aged 42, subject to hypertrophic cirrhosis with jaundice. Churton detected fluctuation, and removed six ounces of clear faintly straw-coloured fluid with an aspirator. Two months later Robson opened the cavity with a Paquelin’s cautery; about eight ounces of fluid came away. Oozing of blood caused great trouble ; it continued for five days, when it ceased, and bile dis- charged freely from the wound ; the jaundice began to disappear. At the end of three weeks local trouble set in with fever, the jaundice remaining stationary. Over a month after the opening of the cyst Robson performed cholecystotomy ; there was a large calculus in the gall- bladder which was removed, and two in the common duct. Bile continued to drain from the opening in the cyst, but only a little bile-stained mucus issued from the drainage track which opened into the gall-bladder. The patient