Abstract

ACUTE EMPHYSEMATOUS cholecystitis is an uncommon disease which was first reported by Welch and Flexner<sup>1</sup>in 1896 as an autopsy finding, the causative organism was<i>Bacillus aerogenes capsulatus (Clostridium perfringens)</i>. Stolz<sup>2</sup>in 1901 described gas in the gallbladder and biliary ducts as an autopsy finding in three patients. Lobinger<sup>3</sup>in 1908 found gas in the gallbladder lumen associated with intramural gas in a patient who was operated on for acute cholecystitis. The first roentgenographic findings were described by von Friederich<sup>4</sup>in 1929, and Hegner<sup>5</sup>in 1931 made the first reported roentgenographic diagnosis in the US by describing the circumferential layer of gas in the gallbladder wall. Edinburgh and Geffen<sup>6</sup>in 1958 reviewed 49 cases published in the world literature and added one of their own. Among these 50 patients, the incidence of diabetes was 24% and that of biliary calculi was 80%. Marshall and

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