THE ASSOCIATION OF HEPATITIS WITH EXPERIMENTAL CHOLECYSTITIS AND ITS BEARING ON THE PATHOGENESIS OF CHOLECYSTITIS IN THE HUMAN

M. G. PETERMAN
1921 Archives of Surgery  
A review of the literature on infections of the biliary tract reveals the fact that there is a wide difference of opinion as regards both the frequency and the nature of an hepatic involvement in association with the relatively simple and more common types of cholecystitis. Such conditions as liver abscess and "obstructive biliary cirrhosis" in association with infections of the biliary tract have long been known. But the changes in the liver which occur in connection with the relatively simple
more » ... e relatively simple types of cholecystitis which are so commonly encountered at operation seem not to have been investigated until the study made by one of us (Graham), the results of which were published in 1918.1 In general, the only evidence of hepatic involvement which has been considered has been an increase in the size of the liver. Kehr 2 quotes Langenbach as saying that an enlargement of the liver is present only with an obstruction of the common duct. Kehr himself considers that the liver may be increased in size in from 15 to 20 per cent, of cases of cholecystitis, namely, in those with cholangitis. There is a more general agreement, however, about the involvement of the liver in cases. in which calculi are present, in other words, in cases of long-standing inflammation of the biliary tract. Thus Grube and Graff 3 state that not uncommonly an interstitial hepatitis which may advance to cirrhosisis found associated with gallstones. Naunyn * quotes Charcot as being the first to call attention to the constancy of an enlargement of the liver in association with gallstones, and he considers that such an hyper-From the
doi:10.1001/archsurg.1921.01110040101005 fatcat:yt6inzscovdjpd7apngmonxvou