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Article
January 18, 1941

DISEASES OF THE COMMON BILE DUCT AND THEIR RELATION TO THE GASTROINTESTINAL TRACT: WITH SPECIAL REFERENCE TO THE ROLE OF CHRONIC PANCREATITIS

Author Affiliations

PHILADELPHIA
From the Services of the Jewish and Mount Sinai hospitals.

JAMA. 1941;116(3):204-208. doi:10.1001/jama.1941.02820030026006
Abstract

It is my purpose in this paper to review briefly some of the common disorders affecting the biliary tract and to call special attention to the importance of the role played by chronic pancreatitis.

According to Walters and Snell1 two types of chronic pancreatitis are recognized, the interlobular type and the interacinar type. Both are characterized by an increase in fibrous tissue, but in the former the islands of Langerhans are spared, while in the latter they are not.

In my experience neither hyperglycemia nor insufficiency of pancreatic secretion (as evidenced by bulky and fatty stools) need be present in cases of chronic pancreatitis that may yet be sufficiently severe to produce symptoms of obstruction of the common duct.

SYMPTOMS  The commonest symptoms of disease of the common bile duct are pain, nausea, vomiting and eructations of gas. Collectively these phenomena are usually called "indigestion" or dyspepsia. Jaundice may

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