A. E. Reddell-Sydney
Giant gallstone measuring 15 x 5 x 5cm, in preservative fluid. Originally from the collections of the Royal Australasian College of Surgeons. From their original record: "How do gall stones form? When the physicochemical environment of the solution in the gall bladder is suitable for precipitation, and such points as saturation, pH, ageing of solutions, nucleus formation are important. Of significance to the surgeon are the factors which give rise to this physicochemical environment. These points are obstruction - such as stricture following trauma, fibrosis of sphincter of Oddi, neoplasm; pancreatitis; infection and apart from the cocci and Gram negative organisms whose origin is debated, there are the actinomycoses. Stasis may follow interference with nervous or humoral mechanisms, such as vagotomy or gastrectomy. Gall stones probably form in one step, and do not grow."