Operative surgery of the gall tracts with original report of twenty successful cholecystenterostomies by means of the anastomosis button / by John B. Murphy.

  • John Benjamin Murphy
Date:
[1894]
Catalogue details

Licence: Public Domain Mark

Credit: Operative surgery of the gall tracts with original report of twenty successful cholecystenterostomies by means of the anastomosis button / by John B. Murphy. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    the ductus choledochus, in which case cholecystectomy should be performed. If the ductus choledochus be occluded, the gall blad- der should be amputated just above the neck, leaving a sufficient portion in vi^hich the button can be inserted in the end, and the approximation made to the duodenum in the usual way. By this operation we provide again a channel for the escape of the bile into the intestinal canal. REPORT OF CHOLECYSTENTEROSTOMIES BY MEANS OF THE ANASTOMOSIS BUTTON. Case I. A. Q , age thirty-five, female; admitted to the medical department of Cook Count)^ Hospital, May 27, 1892. Transferred to the surgical division of the hospital, June 10, 1892, and came under my care. Gave the following history : During the last fifteen years has had stomach troubles ] pain and tender- ness in the epigastrium ; the attack would last from two to four days, was almost always accompanied by vomiting, not by jaun- dice. Had pain in back since childbirth; suffered from chronic constipation. One of these attacks was accompanied by jaun- dice, December 14, 1891. At that time had constant and intense pain for twelve hours, and an aching pain and tenderness in the epigastrium for two months following it. Jaundice cleared in about two months. During the past few months the attacks of stomach trouble would last from twelve to twenty-four hours. In February the present attack began, accompanied by jaundice and severe pruritus, which has been constant from that time up to date. These symptoms increased in severity up to the time she was admitted into the hospital. While in the medical department her jaundice was constant ; her mental condition became very much impaired, and her emaciation rapidly increased. Condition when admitted to the Surgical Department: The patient intensely jaundiced ; very much emaciated ; has a point of tenderness in the right hypochondriac region just below the margin of the rib ; no tumor to be felt. The urine contains a large quantity of bile, no albumin. The patient suffers from considerable mental derangement, very slight elevation of tem- perature. Operation June 11, 1892. I decided to perform cholecj'stenter- ostomy by means of an anastomosis button, which device I had used for the first time on a dog, six days previous. An incision three inches long was made, three inches to the right of the median line, extend-
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