Abstract DESPITE the number of experimental and clinical studies directed toward an understanding of acute cholecystitis, there are many problems concerned with its etiology that remain unresolved. The experimental approaches to the production of acute cholecystitis are numerous and vary according to the concept of disease. Initially investigators emphasized the role of infection and stasis, although clinical observations indicated that the morphologic change in the gall-bladder wall was not characteristic of the change provoked by bacterial infection and that stasis in the absence of obstruction produced no harm. Cultures of the gall-bladder contents as well as of the wall showed a relatively low incidence of positive results in early phases of acute cholecystitis.1 The infrequency of the disease in children, its common association with stone, the infrequency of its association with suppurative disease involving the portal system, its relation to habitus, to obesity, to sex—these and many other clinical observations References 1. Goldman, L.; Morgan, J. H., and Kay, J.: Acute Cholecystitis: Correlation of Bacteriology and Mortality , Gastroenterology 11:318, 1948. 2. Andrews, E., and Henry, L. D.: Bacteriology of Normal and Diseased Gallbladders , Arch. Int. Med. 56:1171, 1935.Crossref 3. Lester, D. J.: Acute Cholecystitis with Special Reference to the Occurrence of Jaundice , Surgery 21:675, 1947. 4. Mann, F. C.: The Production by Chemical Means of a Specific Cholecystitis , Ann. Surg. 73:54, 1921.Crossref 5. Wolfer, J. A.: The Role of Pancreatic Juice in the Production of Gallbladder Disease , Surg., Gynec. & Obst. 53:433, 1931. 6. Colp, R.; Gerber, I. E., and Doubilet, H.: Acute Cholecystitis Associated with Pancreatic Reflux , Ann. Surg. 103:67, 1936. 7. Bisgard, J. D., and Baker, C. P.: Studies Relating to the Pathogenesis of Cholecystitis. Cholelithiasis and Acute Pancreatitis , Ann. Surg. 112:1005, 1940. 8. Gatch, W. D.; Battersby, J. S., and Wakim, W. G.: Nature and Treatment of Cholecystitis , J. A. M. A. 132:119, 1946. 9. Aronsohn, H. G., and Andrews, E.: Experimental Cholecystitis , Surg., Gynec. & Obst. 66:748, 1938. 10. Womack, N. A., and Haffner, H.: Cholesterolosis: Its Significance in the Badly Damaged Gallbladder , Tr. South. S. A. 55:103, 1944. 11. Womack, N. A., and Bricker, E. M.: Pathogenesis of Cholecystitis , Arch. Surg. 44:658, 1942. 12. Wilkie, A. L., and Doubilet, H.: Passage of Cholesterol Through the Mucosa of the Gallbladder , Arch. Surg. 26:110, 1933. 13. Cole, W. H.; Novak, M. V., and Hughes, E. V.: Experimental Production of Chronic Cholecystitis by Obstructive Lesions of the Cystic Duct , Ann. Surg. 114:682, 1941. 14. Rous, P., and McMaster, P. D.: The Concentrating Activity of the Gallbladder , J. Exper. Med. 34:47, 1921. 15. Womack and Haffner.8 Womack and Bricker.9 Wilkie and Doubilet.10 16. Noer, R. J., and Deer, J. W.: Effect of Distention on Intestinal Revascularization , Arch. Surg. 59:542, 1949. 17. Glenn, F. C.: Acute Cholecystitis Following Surgical Treatment of Unrelated Disease , Ann. Surg. 126:411, 1947. 18. Thomas, C. G., Jr., and Womack, N. A.: Symposium on Recent Advances in Surgery: Treatment of Acute Cholecystitis , S. Clin. North America 29:1445, 1949.
A.M.A. Archives Surgery – American Medical Association
Published: May 1, 1952
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