Limy bile cast of gallbladder.

Abstract

N INFREQUENT AND INTFIIESTING CONDITION of the gallbladder is due to the presence of bile containing a high concentration of calcium carbonate, with the result that the gallbladder is radiographically visible even without the administration of dye. The earliest report of calcium bile was made in 1911, by Churchman, z who found a material in the gallbladder which had the consistency of toothpaste. Chemical analysis revealed that this material consisted largely of soaps of calcium salts. The term "milk of calcium" bile was originated by Volkmann," who, in 1926, reported 2 eases in which the gallbladders removed at operation contained a white fluid which proved to be calcium carbonate. In 1931, Phemister and his co-workers 3 reported 7 eases with calcium earbonate gallstones. Knutsson/in 1933, reported 12 eases of calcium carbonate deposits in the gallbladder, and introduced the term "limy bile" in preference to "milk of calcium" bile because he showed that the amorphous material in the gallbladder not ahvays was a thin, milky fluid, but was often a semisolid paste or solid concretion. In 1935, Kornblum and Hall 5 gathered 5 eases, including 1 of their own, in a discussion of the radiographic findings. In 1942, McCall and Tuggle G reported a study of 15 patients with calcium bile. The most reeent report 7 was of a ease of a densely opaque gallbladder fortuitously visualized during a gastrointestinal x-ray series.