A case of very large gall bladder successfully treated by excision / by F.W. Collinson.

  • Collinson, Frederick William.
Date:
1909
Catalogue details

Licence: In copyright

Credit: A case of very large gall bladder successfully treated by excision / by F.W. Collinson. 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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    Reprinted from the British Medical Journal, May 29th, 1909. J Q , SUCCESSFULLY TREATED BY EXCISION* By F. W. COLLINSON, M.D.Edin., M.R.C.P.Lond., F.R.C.S.Edin., HONORARY MEDICAL' OFFICER, PRESTON ROYAL INFIRMARY. This case is remarkable owiDg to the immense size of the gall bladder, being amongst the largest on record. Mrs. 8., aged 31, was sent to me by Dr. Callanan of Longridge on October 14th, 1908, suffering from general abdominal distension and pain in the right side of the abdomen. History. There was nothing of note in the family history, as all were healthy; the mother had died in childbirth. The patient her- self had always been in good health, though pale. She had two children, now living and healthy, born six and three years ago, with one miscarriage in between them. The history of the present affection appeared to date from August, 1907, when she had a fall, for soon after she began to vomit each day, and in December she remained in bed on that account. She distinctly said there was then no swelling of the abdomen. In January she observed a swelling of the lower part of the abdomen towards the right side. On February 13th she had greatly increased in size, and was somewhat emaciated and markedly jaundiced. She was tapped, and 25 pints of fluid was drawn off, and the fluid must have been similar to that removed afterwards at the operation. Dr. Callanan was able to “ feel the liver for 2 in. or 3 in. below the ribs,” but he also wrote, rather prophetically, “ this may, of course, be the sac of a cyst.” It might have been the cyst contracted, but it was more likely to be the liver, as the cyst would tend to fall away from the liver in all probability, for there would not be any adhesions at the first tapping, as they would arise from oozing after the puncture. Her general health improved, and the jaundice diminished. She, however, began to refill, and on April 10th 25 pints were again drawn off. Her general health still further improved, and her menstruation, which had ceased in the December, recommenced in June, and was regular up to the operation. Condition when First Seen. Upon examination there was no cachexia or jaundice and her pulse and temperature were normal. Excepting the evident enlargement of the abdomen there did not appear to be much the matter with her. The circumference at the umbilicus was 40 in., although she is short in stature. The abdomen did not * Notes read, and patient shown, to the Clinical Branch of the Preston Medico-Ethical Society, February 3rd, 1909. [IW/Oll]