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Article
April 19, 1930

A CAUSE OF ADHESIONS IN THE RIGHT UPPER QUADRANT

JAMA. 1930;94(16):1221-1222. doi:10.1001/jama.1930.02710420033012

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Abstract

For several years it has been my custom to make a thorough survey of the abdominal contents in nearly all cases in which the abdomen is opened. This examination differs materially from casual notation of the condition of the gallbladder and the appendix, such as is common practice with gynecologists. Palpation is conducted with painstaking gentleness, as well as thoroughness; I aim always to be so gentle that patients under light anesthesia are not aroused or stimulated to strain because of the forcefulness or harshness of manipulation.

Thorough routine examination, as indicated, has led to the discovery that there is a frequent incidence of "violin-string" adhesions between the anterior surface of the liver and the anterior abdominal wall. I wish particularly to emphasize the location and the character of these adhesions in distinction from isolated adhesion bands and commonly encountered liver-kidney or gastrohepatic adhesions or adhesions on the under surface

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