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July 1932

Problème sous-hepatiques.

Arch Intern Med (Chic). 1932;50(1):169-170. doi:10.1001/archinte.1932.00150140176016

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The author considers three problems in the subhepatic region: anatomy, pain and tumors. He spends considerable time emphasizing the fact that the relationship of the gallbladder to adjacent structures in the living subject is different from that observed in the cadaver. The relationships also change with different positions of the body and with pathologic processes. He advises the use of the Trendelenburg position for examination.

Acute and chronic painful conditions in the subhepatic region are discussed, and differential diagnosis is considered. Three types of pain in the gallbladder are described. One is mechanical, owing to the passage of gallstones, another is caused by infection, and the third, "colloidoclosique," is due to an unstable vegetative nervous system and endocrine factors. Treatment is given as follows: for the mechanical type, injections of morphine; for the infectious type, opium, antipyrine for the fever (given by enema if necessary) and local applications of heat,

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