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JOHN J. BYRNE, M.D.; ROBERT L. BERGER, M.D.

AMA Arch Surg. 1960;81(5):812-816.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

The pathogenesis of acute cholecystitis is primarily due to obstruction of biliary outflow by a stone. Other rare causes may be stricture, kinking of the cystic duct, intussusception of a polyp, torsion of the gallbladder, pressure of an overlying lymph node on the cystic duct, or inspissated and concentrated bile. As the gallbladder distends following the obstruction, the blood vessels in the gallbladder wall become compressed, giving rise to a patch of gangrene on the fundus which can rupture and produce bile peritonitis. In addition to these mechanical and vascular factors various investigators have favored infection or chemical irritation as the cause of this disease.

Graham and Peterman¹ were probably the last to emphasize the role of infection and to delineate the anatomical pathways of such infection. Since infection was present in the wall of the gallbladder before it involved the mucosa, they believed that the route of infection . . . [Full Text PDF of this Article]

Author Affiliations
Boston

Director, Third (Boston University) Surgical Service and Research Laboratory, Boston City Hospital; Professor of Surgery, Boston University School of Medicine (Dr. Byrne); Resident, Third (B.U.) Surgical Service, Boston City Hospital (Dr. Berger).

Footnotes
Submitted for publication April 15, 1960.

This work was supported by a grant from the United Fund of Quincy, Mass.

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