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September 21, 1946


Author Affiliations

Indianapolis; Bloomington, Ind.

JAMA. 1946;132(3):119-121. doi:10.1001/jama.1946.02870380001001

The idea that infection is the sole cause of cholecystitis still prevails and still governs treatment. The evidence against it, which has been accumulating for the past twenty years, is just beginning to appear in textbooks on surgery. Likewise, the idea that cholecystitis is caused primarily by chemical action has made slow headway, though the reasons for believing it are compelling. Writers on the cause of cholecystitis have considered chiefly experimental observations on diseased human gallbladders. They have been slow to suggest the clinical application of their conclusions. Practice is not abreast of knowledge. These facts seem to justify the present paper.


Infection.—  The pertinent facts on the relationship of infection to cholecystitis are the following:

  1. Cholecystitis is rare in children, although infections are more commonly observed in children than in adults.

  2. In about two thirds of all cases of cholecystitis the bile is sterile. The