Diseases of the liver, gall-bladder and bile-ducts.

  • Humphry Rolleston
Date:
1905
Catalogue details

Licence: In copyright

Credit: Diseases of the liver, gall-bladder and bile-ducts. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

    33/852 (page 13)
    Incidence.—Tongue-shaped lobes are much more frequent in women. This depends on their causation, both tight lacing and cholelithiasis being much commoner in that sex. Anatomy.—The tongue-shaped lobes may either taper off gradually into an elongated, thick process from the right lobe, or the connecting pedicle may be reduced to two layers of somewhat thickened peritoneum. In the latter case the tongue-like lobe is freely movable, and during life may appear to be quite distinct from the hver. The gall-bladder may, but need not, be situated on the under surface of the tongue-like lobe, as in two cases excised during Ufe (Martin, Bastianelli); the cystic duct ' i.ound iigaiin'ijl. f Kieilel's lobe. Flli. S.—Snows THE LlVKll WI TH KllCD10J>'!i TONriUK-LIKB liOBB AND AREAS OF SUPI'lTRATION ])UK TO Supi'UKATivn Cholangitis. From a case of cliolecysto-colic fistula cine to gall-stones. (Drawn by Dr. K. A. Wilson.) will then run across the pedicle. As a rule, the tongue-like lobe is not perfectly normal in structure; from repeated attacks of congestion it may show fibrosis, and degeneration, atrophy, and pigmentation of the liver cells, and hfemorrhages. It has been found to be affected with gummata when the remainder of the liver was healthy, and may be the seat of secondary new-growth. (Compare p. 9.) Roux * has described primary carcinoma starting in a tongue-like lobe. In his case there WcOs calculous cholccy.stitis. In similar ca.ses care must lie taken to see that the growth docs not start in what is a mucli commoner situation, viz., the walls of the gall-bladder. * Roux: Rev. MC'd. de la Sui.s.se Romande, Feb. 20, 1S97.