Search

Thirty-seven patients with acute cholecystitis and jaundice were studied intraoperatively with cholangiomanometry, and a mechanical lesion explaining the jaundice was found in 23. Six others had probably passed a stone, and one had hepatitis. Several inflammatory factors in this group, when compared with a group of 36 nonjaundiced patients with acute cholecystitis, showed no difference. Several causes for jaundice exist, but nonmechanical inflammatory theories are doubted.

A woman, who had lived in equatorial Africa, complained of pain in the right hypochondrium. Roentgenography revealed a calcified mass in the liver. The mass was removed surgically and was found to contain eggs of Fasciola gigantica, a fluke that rarely infests humans. The roentgenographic appearance of the lesion (its large size, uneven density, and polycyclic configuration) was distinct from that produced by other causes of hepatic calcification.

At the present time, no technique of heterotopic liver transplantation is capable of sustaining life in reproducible fashion unless portal blood is supplied to the graft. However, suppression of the portal blood risks compromising the function and eventual regeneration of the host liver, particularly if such a technique is to be used in the treatment of acute hepatic failure. The failure of heterotopic hepatic transplantation without portal blood may be due in part to unfavorable hemodynamic conditions. Livers grafted by a technique of intrathoracic homograft that aims to reproduce hemodynamic conditions close to the normal as regards inflow and venous drainage are capable of maintaining life in the hepatectomized dog.