A Clinical Study of Cholecystitis with the Aid of Cholecystography

Abstract

PRIOR to the advent of gall-bladder visualization by the Graham-Cole-Copher method, the roentgenologic evidence of cholecystic disease was very scant, and consisted chiefly in the visualization of gallstones having sufficient calcium to be opaque. George, Kirklin and Arens have attached great significance to the visualization of the gall bladder in pathological cases by virtue of its intrinsic density or viscosity of contents, and recently Arens has noted positive gall-bladder shadows in 88 per cent of 25 operatively confirmed cases. Great stress is also laid upon the secondary indications, i.e., imprints on contiguous structures, duodenal fixation and, in a lesser measure, “duodenal churning.” It has been our experience that the visualization of the gall bladder without dye, while occasionally seen in gall-bladder disease, not infrequently occurs in normal cases. This also applies to the indirect signs. Carman has demonstrated definite gall-bladder shadows in cholecystectomized patients. Mills often rema...