The Medical and scientific archives of the Adelaide Hospital. No. 4.

  • Adelaide Hospital (Adelaide, S. Aust.)
Date:
1925
Catalogue details

Licence: Public Domain Mark

Credit: The Medical and scientific archives of the Adelaide Hospital. No. 4. Source: Wellcome Collection.

    4/56 (page 4)
    I.—HYDATID DISEASE. During 1924 seven cases of hydatid disease have been under surgical care at the Adelaide Hospital. These cases do not call for any special comment in this place. At autop-sies hydatid cysts were found in five cases out of a total of 222 post-mortems. In all these cases the presence of such a cyst was entirely unsuspected. In four of the cases they were degenerated, and in no way contributed towards death, and probably for many years had given rise to no symptoms if they had ever done so. In the other case a very large •degenerating cyst was present in the liver; the stomach, in conse¬ quence, had been pushed over to the left, and it was thought that the presence of this large cyst had probably contributed to the patient’s death. As pointed out in previous numbers of the Archives, it would seem that about 2 per cent, of adults dying in this State are infested by hydatid cysts, usually unsuspected and undergoing degeneration. (i) hydatid disease of the lung causing chronic EMPYEMA. (Under the care of Dr. Cndmore, Eon. Surgeon. Notes by Dr. 1. B. Jose, Registrar.) E. P., male, cet. 63, was admitted on October 16th, complaining of pain in the chest and dyspnoea, which he had had for 10 months. He stated that he had had an hydatid of the liver operated on 27 years previously, followed by an hydatid of the lung, which ruptured into a bronchus, and for the last 25 years had caused periodical coughing-up of hydatid cysts. In January, 1924, he was X-rayed by Dr. King, of Mount Gambier. A dense shadow was apparent in the right axillary region of the chest. The chest was opened, and a large cavity found lined by calcified plaques and connected by a small sinus to a bronchus of the collapsed lung. The wound had discharged con¬ stantly since the operation, and had been painful. An X-ray showed a localised pneumothorax limited by thickened pleura and adhesions in the right eostcphrenic angle. No suggestion of an hydatid was apparent in the lung fields. On October 31st an operation was performed to increase the drainage opening and to resect portions of the adjoining ribs to allow the chest wall to fall in and obliterate the cavity. The wound had healed by November 17th, when he was discharged well. (2) HYDATID CYST OF THE LIVER WITH JAUNDICE. (Under the care of Dr. H. Newland, Eon. Surgeon. Notes by Dr. I. B. Jose, Registrar.) A. J., male, cet. 34, was admitted on August 19th, complaining of pain in the right hypochondrium, of sudden onset three weeks previously. He had been in fair health before this. He had vomited food once soon after the onset, of the pain, which was sharp and stabbing in attacks, with periods of aching, but comparative freedom. During this time he had been feverish, and on admission his tempera¬ ture was 104° F. He had had dysentery in Egypt eight years ago, an attack of abdominal pain two years ago, and pain between the shoulder blade one year ago. On examination the patient was jaundiced, and had several scratch marks and purpuric spots on the arms and chest. There was deep tenderness in the right epigastric region, and rigidity of the. upper part of the right rectus, and a moveable mass could be felt projecting from under the right costal margin. A white cell count showed