The Murphy button : with a report of an unsuccessful cholecystduodenostomy / by Aug. Schachner.

  • August Schachner
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: The Murphy button : with a report of an unsuccessful cholecystduodenostomy / by Aug. Schachner. 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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    having been suggested some time previ- ously. He was removed to an infirmary and an exploratory opening made directly over the gall-bladder. The liver was enlarged and felt abnormally hard. The gall bladder was full, but hardly distended. Palpitation and examination revealed nothing. The gall- bladder was aspirated, drawing off about three ounces of healthy-looking bile. The interior of the bladder was now explored with a probe, with negative result. The gall-bladder was incised and the duct ex- amined, but only with partial satisfaction. Everything being in readiness, and taking his past history in consideration, I con- cluded that the most logical course would be to drain the bladder into the intestine, thereby hoping to effectually relieve those rapidly increasing colics and arresting his downward tendency. In performing the operation the chief difficulty experienced was the hemorrhage from both the intestinal and hepatic side. The intestines had also become a source of annoyance by continually coming into the field of operation. Finally the anastomosis was completed and, after carefully cleans- ing the parts preparatory to closing the abdomen, a small leak was suddenly dis- covered at the upper edge. This was due to a slight tear of the intestinal wall, which, owing to its friable condition, had been a source of trouble. It was closed by a running Lembert stitch, which extended two-thirds of the way around. The patient was removed in good condition. His course for the succeeding thirty-six hours lO
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