Abstract
The patient, Mrs. X., 37 years of age, was referred for gall-bladder examination. Three years previous to this time, she had experienced an acute pain in the right upper quadrant, which was scarcely relieved by morphia. Following that attack, she was in good health for over two years, until June, 1926, when the pain recurred at intervals of two or three weeks. It was, however, not so acute as at the previous attac k. Iodeikon was administered twice, but the gall bladder was not visualized either time. The patient was then given a barium meal, whereupon a pouch was seen in the external part of the second portion of the duodenum, surmounted by a gas bubble which showed peristaltic waves on its lower contour. The diagnosis considered three possibilities: (1) probable gall-bladder disease; (2) adhesions; (3) diverticulum. Upon operation, about thirty stones were found in the gall bladder, the largest of which was impacted in the cystic duct. There were so many adhesions and the dissection of the gall bladder ...
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