Abstract
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.
Full Text
The Full Text of this article is available as a PDF (642.8 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- McMaster P. D., Broun G. O., Rous P. STUDIES ON THE TOTAL BILE : I. THE EFFECTS OF OPERATION, EXERCISE, HOT WEATHER, RELIEF OF OBSTRUCTION, INTERCURRENT DISEASE, AND OTHER NORMAL AND PATHOLOGICAL INFLUENCES. J Exp Med. 1923 Feb 28;37(3):395–420. doi: 10.1084/jem.37.3.395. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McMaster P. D., Rous P. THE BILIARY OBSTRUCTION REQUIRED TO PRODUCE JAUNDICE. J Exp Med. 1921 May 31;33(6):731–750. doi: 10.1084/jem.33.6.731. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rous P., Larimore L. D. RELATION OF THE PORTAL BLOOD TO LIVER MAINTENANCE : A DEMONSTRATION OF LIVER ATROPHY CONDITIONAL ON COMPENSATION. J Exp Med. 1920 Apr 30;31(5):609–632. doi: 10.1084/jem.31.5.609. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rous P., Larimore L. D. THE BILIARY FACTOR IN LIVER LESIONS. J Exp Med. 1920 Jul 31;32(2):249–272. doi: 10.1084/jem.32.2.249. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rous P., McMaster P. D. A METHOD FOR THE PERMANENT STERILE DRAINAGE OF INTRAABDOMINAL DUCTS, AS APPLIED TO THE COMMON DUCT. J Exp Med. 1923 Jan 1;37(1):11–19. doi: 10.1084/jem.37.1.11. [DOI] [PMC free article] [PubMed] [Google Scholar]