Report of a Case of Acquired Hemolytic Jaundice With Splenectomy

Abstract

small bougie was passed from the mouth, and on the with¬ drawal of the sound the bougie was carried into the stomach. This was gently pulled all the way into the stomach cavity, and successive sizes passed until a fairly large dilation was obtained.During this manipulation the lemon seed was pushed into the stomach; it was of usual size and was intact from its position in the esophagus. After these manipulations had been carried out, a rubber tube was sutured into the stomach wall after the method of Senn.Postoperative Course.-For the first twenty-four hours the patient had a rather stormy course, but after this his condition rapidly improved, and at the end of the fourth day he was able to take food by mouth with a fair degree of comfort. At the end of the sixth day graduated bougies were passed twice a day, and at the end of the ninth day the tube in the stomach was removed, and the patient left the hospital on the fifteenth day.Since his discharge from the hospital he has kept up the passing of the bougies, which has been about twelve months. He eats anything and has had absolutely no trouble with the passage of food through the esophagus.He has now gained 40 pounds and works every day as a section hand on one of the railroads which come into the city.While a great deal has been written and elaborate studies and experiments have been made to determine the nature of hemolytic jaundice, it was not until 1898, that Hayem,1 through a study and analysis of cases, first showed that the familial and the acquired types were two entirely separate and definite conditions. Since then many experimenters and clinicians have substantiated his conclusions. A review of the summary on hemolytic jaundice made in 1915 by Elliott and Kanavel,2 who were the first in this country to