The fact that bile peritonitis is highly fatal has long been recognized by surgeons. It has been demonstrated repeatedly that bile injected intravenously or intraperitoneally into animals is toxic. The first extensive study of this subject was made by von Dusch1 in 1854. Since that time many valuable contributions have been made, but a great deal of the pathology remains unexplained.
Bunting and Brown2 either cut the gallbladder of rabbits and allowed the bile to escape into the peritoneal cavity or injected intraperitoneally from 0.25 to 0.5 cc. of bile per kilogram of body weight. Death occurred in less than twenty-four hours and was attributed to direct action on the myocardium, which revealed degenerative changes. The local pathologic effects which were observed may be summarized in the statement that bile produced necrosis of every type of tissue with which it came in contact. This work was repeated by
DAVIDSON EC, EMERSON WC. INFLUENCE OF THE LIVER ON TOXICITY OF BILE. Arch Surg. 1927;15(1):57-65. doi:10.1001/archsurg.1927.01130190060004