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In the New York Medical Journal, January 31, Dr. Colegrove reports the passage of an extraordinarily large biliary calculus by the way of an umbilical fistula. A lady, aged 83, had an abscess around the umbilicus, attended with a great amount of disturbance, pain, loss of sleep and appetite; it communicated externally by means of a fistula, through which pus was discharged for a week or more. One night she was suddenly taken with an increase of the pain, so intense that she became collapsed; with this there was the extrusion, through the umbilical fistula, of a calculus measuring four inches in circumference. Two months later the fistula had healed and there was a complete absence of local tenderness, and the patient was restored to her former measure of health.
LARGE BILIARY CALCULUS DISCHARGED THROUGH AN UMBILICAL FISTULA.. JAMA. 1891;XVI(8):276. doi:10.1001/jama.1891.02410600024009