Cholelithiasis : fourteen thousand calculi removed at operation.

  • August Schachner
Date:
1911
Catalogue details

Licence: In copyright

Credit: Cholelithiasis : fourteen thousand calculi removed at operation. 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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    CHOLELITHIASIS—FOURTEEN THOUSAND CALCULI REMOVED AT OPERATION. With a view of adding- to the literature of gall-stone surgery, the following case is reported, believing that the very unusual number of stones found fully justifies its presentation. The patient was an unmarried woman, aged 52 years, who was referred to me through the kindness of Dr. George F. Simpson. Her family and personal history were negative. Eighteen years ago she first experienced epigastric pain and vomiting. Pain came suddenly and disappeared suddenly. No further trouble for months. Then renewed attack with moderate pain and nausea but no vomiting. About a year thereafter a third attack occurred similar to the preceding. Then followed a period of quiescence lasting four or five years. After this attacks recurred about every six months. About eight years ago patient began having attacks every month, and noticed that there was a tendency for them to increase in severity, hold on longer, and return more frequently. At times they would continue throughout the night. Recently the attacks increased decidedly in frequency and severity. Nearly always vomited. No jaundice at any time. Marked chronic constipation. Pain at the ensi- form cartilage, or to the right, and when it radiated it would be about the right rib toward the inferior scapular angle. Dur- ing the last four years she lost 50 pounds in weight. Operation: In the presence of Dr. Jacob Weber, Dr. Paul H. Greenleaf, of Lexington, Illinois, and with the assistance of Dr. George F. Simpson, the operation was performed at St. Mary and Elizabeth Hospital. An attempt to aspirate the bile by means of a trocar was made without success. Upon withdraw- ing the trocar, it was found to be clogged with a number of small stones. The appearance of the gall-bladder being perfectly sym- metrical, it was not suspected that its distention was absolutely and literally due entirely to the stones. It was incised and the stones removed. The wall of the gall-bladder was twice the usual 59i
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