Acute cholecystitis without gallbladder stones

Abstract

1. 1. A series of fourteen patients in whom acute inflammatory changes developed in the gallbladder in the absence of gallstones is reported. 2. 2. Obstruction of the cystic duct by a malignant tumor, fibrosis, or an anomalous cystic artery appeared to be the etiologic factors in some of the patients. 3. 3. Reflux of pancreatic juice into the gallbladder via a “common channel” appeared to be a probable cause in other patients. The triggering mechanism was assumed to be coexistent acute or chronic pancreatitis, common duct stone (one case), or spasm of the sphincter of Oddi (one case). 4. 4. In one case of acute ulcerative hemorrhagic cholecystitis the patient had chlorpromazine hepatitis, and in another, the only woman in the series, the patient was under treatment for chronic pemphigus. 5. 5. The operating surgeon should remember these possible causes of acute noncalculous cholecystitis, especially if cholecystostomy without exploration was performed, since some of these patients may benefit by further surgery.