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.

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    fixation test was negative on July 1st. On July 4th laparotomy was performed, and a hydatid cyst was found arising from the under surface of the liver, and covered over by the lesser omentum. The abdominal cavity was packed off, and the cyst brought to the surface, evacuated of clear hydatid fluid and membrane (no daughter cysts were present), and marsupialised. Recovery was uneventful, and she was discharged to outpatient treatment on July 18th, with a small sinus discharging a little. (5) GENERALISED HYDATID DISEASE OF THE PERITONEUM. i(Under the care of Dr. Cudmore, Hon. Surgeon. Notes by Dr. I. B. Jose, Registrar.) P. C., male cet. 21, octoroon, was admitted on January 1st, 1924, complaining of pain in the unbilical and right iliac regions of sudden onset, and unaccompanied by nausea or vomiting or any urinary symptoms. He gave a history of having received a kick in the abdomen a year ago, which had laid him up for one week, and that he had had abdominal pain on and off since. On examination the muscles of the lower abdominal wall were “on guard,’’ there was no hyperaesthesia, but a tender mass could be felt in the right iliac region. Rectal examination showed a tense cystic somewhat tender mass lying in front of the rectum. On January 2nd laparotomy was performed, and a hydatid cyst 3in. in diameter was found in the right iliac fossa atached to' a long pedicle of omentum which had undergone torsion. The pedicle and cyst were removed. A second cyst in the right lumbar pouch was also removed. A third cyst lying between the bladder and rectum was opened and evacuated of contents and mem¬ brane. The omentum was studded with thousands of minute cysts. Recovery from the operation was uneventful. (6) RECURRENT HYDATID DISEASE OF THE ABDOMEN. (Under the care of Dr. Mainwaring, Hon. Surgeon. Notes by Dr. I. B. Jose, Registrar.) M. I., female, cet. 65, was admitted on January 2nd, 1924. She had had an operation for hydatid disease of the liver in February, 1905. In 1919 she had another operation for marsupialisation of a large hydatid of the under surface of the left lobe of the liver and removal of an obsolescent hydatid of the great omentum. She now complained of ‘1 nagging’’ pain in the sides and back, and a feeling of fullness in the liver region, and frequency and urgency of micturition. There was no vomiting or nausea as on the previous occasions. On examination of the chest, the percussion note was impaired over the lower lateral part of the right chest up to the fifth intercostal space in the mid-axillarv region, and a friction rub was present. A smooth founded mass could be felt extending into the abdominal cavity from the under surface of the right lobe of the liver opposite the tenth right costal cartilage. This was 3in. in diameter, moveable with the liver, and dull on percussion. Vaginal examination showed a soft cystic swelling in the pouch of Douglas, which was thought to be an hydatid cyst. Blood examination gave a weak positive hydatid complement fixation test and a weak positive precipitin test, and an eosinophilia of 3 per cent. X-ray examination of the chest showed an irregularity of the right diaphragmatic outline, probably due to adhesions, and a small round opacity at the left cardio-phrenic angle, which appeared to be a hydatid cyst connected to the