scholarly journals STUDIES ON THE TOTAL BILE

1923 ◽  
Vol 37 (5) ◽  
pp. 685-698 ◽  
Author(s):  
Philip D. McMaster ◽  
G. O. Broun ◽  
Peyton Rous
Keyword(s):  
High Pressure ◽  
Gall Bladder ◽  
Biliary Obstruction ◽  
Physiological Factors ◽  
Partial Obstruction ◽  
White Bile ◽  
Liver Changes

In bile that is secreted against an abnormally high pressure, as during partial obstruction, the pigment, cholate, and cholesterol outputs are all cut down, and so much more than is the fluid bulk that the concentration of the substances per cubic centimeter of bile is notably lessened. The fluid obtained at the greatest pressure compatible with secretion contains traces only of the typical biliary constituents. The bearing of these alterations in the bile on the consequences of partial biliary obstruction is discussed. An analysis of the liver changes following biliary obstruction brings out their essential likeness to the changes that occur under similar circumstances in glands in general and the kidney in particular. The major physiological factors concerned in the development of hydronephrosis and in the liver changes after biliary obstruction are identical. We would suggest that the term hydrohepatosis as applied to the liver condition would be useful not merely to designate it but to indicate the principles underlying its development. In clinical instances of biliary obstruction, the likeness to hydronephrosis is often hidden because of the activity of the gall bladder to render the stasis bile dark and thick. There is then a concealed hydrohepatosis, differing merely by the character of the duct content, from the manifest hydrohepatosis with "white bile," that is found when the gall bladder fails to act.

scholarly journals Candida albicans cholecystitis with associated hepatitis in a cat

2019 ◽  
Vol 5 (1) ◽  
pp. 205511691985416
Author(s):  
Shannon M Palermo ◽  
Ashleigh W Newman ◽  
Michael W Koch
Keyword(s):  
Candida Albicans ◽  
Hepatic Encephalopathy ◽  
Gall Bladder ◽  
Biliary Obstruction ◽  
Domestic Animal ◽  
Fungal Culture ◽  
Cytologic Examination ◽  
Case Summary ◽  
Obstructive Cholestasis ◽  
White Bile

Case summary A 3-year-old male neutered domestic shorthair cat was presented for vomiting, inappetence and icterus. Biochemical results and ultrasonographic findings were consistent with cholestasis and possible biliary obstruction. A diagnosis of Candida albicans cholecystitis with associated hepatitis was made following cytologic examination and fungal culture. Progressive hyperbilirubinemia and hepatic encephalopathy were ultimately fatal. Relevance and novel information To our knowledge, this is the first report of biliary candidiasis diagnosed by cytologic examination of a cholecystocentesis sample in a domestic animal with no evidence of immunodeficiency. Additionally, this is the first reported case of fungal cholecystitis with associated white bile syndrome due to obstructive cholestasis, without an overt gall bladder mucocele.

scholarly journals Utilizing the gall bladder as a conduit in treating biliary obstruction: a historical perspective

2017 ◽  
Vol 87 (3) ◽  
pp. 110-111 ◽  
Author(s):  
Manjuka Raj ◽  
Eunice Lee ◽  
Christopher Christophi ◽  
Vijayaragavan Muralidharan
Keyword(s):  
Gall Bladder ◽  
Biliary Obstruction ◽  
Historical Perspective

Presence of white bile in malignant biliary obstruction is associated with poor prognosis: personal preliminary observations

2006 ◽  
Vol 392 (1) ◽  
pp. 61-65 ◽  
Author(s):  
Girolamo Geraci ◽  
Carmelo Sciumè ◽  
Franco Pisello ◽  
Francesco Li Volsi ◽  
Tiziana Facella ◽  
...  
Keyword(s):  
Biliary Obstruction ◽  
Poor Prognosis ◽  
Malignant Biliary Obstruction ◽  
White Bile

scholarly journals PHYSIOLOGICAL CAUSES FOR THE VARIED CHARACTER OF STASIS BILE

1921 ◽  
Vol 34 (1) ◽  
pp. 75-95 ◽  
Author(s):  
Peyton Rous ◽  
Philip D. McMaster
Keyword(s):  
Specific Gravity ◽  
Gall Bladder ◽  
Functional Activity ◽  
Bladder Wall ◽  
Clinical Consequences ◽  
Bladder Activity ◽  
Biliary Stasis ◽  
White Bile ◽  
The One ◽  
Considerable Pressure

The gall bladder and ducts exert opposite influences upon the bile. The ducts fail to concentrate and thicken it with mucus as the bladder does, but dilute it slightly with a thin secretion of their own that is colorless and devoid of cholates even when the organism is heavily jaundiced. The fluid may readily be collected into a rubber bag connected with an isolated duct segment. It continues to be formed against a considerable pressure, and, in the dog, is slightly alkaline to litmus, clear, almost watery, practically devoid of cholesterol, and of low specific gravity to judge from the one specimen tested. In obstructed ducts separated from the gall bladder, or connecting with one so changed pathologically that the concentrating faculty has been lost, such fluid gradually replaces the small amount of bile originally pent up. It is the so called "white bile" of surgeons. When obstructed ducts connect with an approximately normal gall bladder the stasis fluid is entirely different, owing to the bladder activity. At first there accumulates in quantity a true bile much inspissated by loss of fluid through the bladder wall, darkened by a change in the pigment, and progressively thickened with bladder mucus. As time passes duct secretion mingles with the tarry accumulation and very gradually replaces it. The inspissation of the bile, as indicated by the pigment content, is at its greatest after only a day or two of stasis. The differing influences of the ducts and bladder upon the bile must obviously have much to do with the site of origin of calculi and their clinical consequences. The concentrating activity of the bladder cannot but be a potent element in the formation of stones. We have discussed these matters at some length. Intermittent biliary stasis is admittedly the principal predisposing cause of cholelithiasis; and the stasis is to be thought of as effective, in many instances at least, through the excessive biliary inspissation for which it gives opportunity. In this way a normal gall bladder can become, merely through functional activity, a menace to the organism. In patients with the tendency to stones frequent feedings may lessen the danger of their formation.

scholarly journals Permanent External Biliary Catheter: A Difficult Problem Managed by Rescue Technique of Hepaticocholecystogastrostomy

2021 ◽  
Author(s):  
Vikas Singla ◽  
Ajit Kumar Yadav ◽  
Anil Arora ◽  
Arun Gupta
Keyword(s):  
Gall Bladder ◽  
Biliary Drainage ◽  
Biliary Obstruction ◽  
Difficult Problem ◽  
Biliary System ◽  
Percutaneous Biliary Drainage ◽  
Rescue Technique ◽  
External Drain

AbstractPercutaneous biliary drainage is commonly performed procedure after failure of ERCP in patients with biliary obstruction. Failure to internalization can lead to permanent external catheter. In the present case, problem of external biliary catheter was solved with hepaticocholecystogastrostomy. Guidewire from the external drain site could not be passed across the stricture, instead it was entering in the gall bladder. This was used as an opportunity to internalize the catheter. First EUS guided cholecystogastrostomy was performed, followed by placement of stent between right biliary system and the stomach, through the cholecystogastrostomy stent. This led to drainage of right biliary system into the stomach, and the external catheter could be removed.

scholarly journals STUDIES ON UROBILIN PHYSIOLOGY AND PATHOLOGY

1926 ◽  
Vol 43 (6) ◽  
pp. 753-783 ◽  
Author(s):  
Philip D. McMaster ◽  
Robert Elman
Keyword(s):  
Gall Bladder ◽  
Biliary Tract ◽  
Cystic Duct ◽  
Experimental Infection ◽  
Liver Tissue ◽  
Biliary Obstruction ◽  
Bile Ducts ◽  
Liver Parenchyma ◽  
Active Absorption

Experimental infection of the intubated and previously sterile biliary tract of the dog with particles of the stools leads to a formation of urobilin from the bilirubin of the bile as it flows through the ducts. No urobilinuria occurs, however, unless temporary biliary obstruction is produced, or the liver parenchyma injured. Then urobilinuria develops, despite the fact that no bile is reaching the intestine and, by corollary, no urobilin being formed there. Cholangitic urobilinuria, as one may term the phenomenon just described, to distinguish it from the urobilinuria having origin in pigment absorbed from within the intestine, is far more pronounced in animals possessing a healthy gall bladder than in those with a pathological gall bladder or with one prevented from functioning by severance of the cystic duct. These facts suggest that there may be an active absorption of urobilin from the normal gall bladder. There can be no doubt that the pigment is absorbed from within the bile ducts. There is no evidence whatever to justify the belief that urobilin is ever formed through the action of liver parenchyma. There may conceivably be an intralobular formation of the pigment consequent upon the activity of bacteria within the liver tissue, though such a happening has yet to be demonstrated.

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