Intestinal obstruction due to gall-stones : report of three cases, with summary of five more cases from the records of the London Hospital, 1893-1901 / by H.L. Barnard.

  • Barnard, Harold Leslie, 1868-1908.
Date:
[1902]
Catalogue details

Licence: In copyright

Credit: Intestinal obstruction due to gall-stones : report of three cases, with summary of five more cases from the records of the London Hospital, 1893-1901 / by H.L. Barnard. 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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    slightly jaundiced. Her pulse was rapid and small. The abdo- men was tender and distended. Laparotomy was performed on the day of admission, and a gall-stone was found several feet above the ileocaecal valve. The gut above was greatly distended and congested, below it was contracted and empty. Enterotomy was performed and the stone evacuated through the wound; two small stones were found above it, and these fitted facets on the larger one. The stone which caused the obstruction was one and three-quarters inches long, one inch in diameter, and three and one-eighth inches in its greatest circumference. It weighed 191 grains. It was dark brown, and at its larger end presented four facets. The two smaller stones presented four facets each. It was clear that two or more other calculi were missing. The wound in the gut was closed in a similar manner to that described in the previous cases. Progress.—The woman made an uninterrupted recovery, saving a sudden attack of collapse on the fourth day after the operation, for which no cause was found and from which she rallied. She was discharged quite well from the hospital a month later. This case was recorded in the Pathological Society Transac- tions, 1896, Vol. xlvii, page 95.2 Case VII.—H. S., aged fifty-two years, was admitted to the London Hospital on October 24, 1898, under the care of Mr. McCarthy. He was in a state of profound collapse from acute intestinal obstruction. For ten days he had been vomiting, and latterly this had been faecal. For four days he had suffered from absolute constipation. The patient was too collapsed for an oper- ation to be performed. He died the day after admission. Post-Mortem.—A large gall-stone was found impacted in the ileum, twenty-five inches from the caecum. A fistula bimucosa was found connecting the gall-bladder and duodenum, which were united by peritoneal adhesions. Commencing peritonitis was present all over the small gut. Case VIII.—S. N., aged fifty years, was admitted under the care of Mr. T. H. Openshaw, on November 27, 1899, suffering from acute intestinal obstruction. Previous History.—She had never had an attack of jaundice. Twelve months before admission, she had a severe attack of ab- dominal pain, which came on suddenly and was spasmodic in
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