Study of the bile obtained by means of duodenal drainage in man can give significant data regarding inflammation of the gallbladder. For instance, the presence of desquamative elements originating in the biliary tract (cells; leukocytes) is important evidence of cholecystitis. The difficulty at times consists in deciding whether the elements have come from the gallbladder, the extrahepatic bile ducts or the liver. This applies also to the presence of albumin in the bile. Faulty evacuation of the gallbladder is a sign which is present in cholecystitis; as it is a negative sign and appears in association with other diseases also, it is of much less importance.
Since cholecystitis is a common disease, it is useful to have multiple methods for its diagnosis. For many years I have studied the possibility of making a diagnosis of cholecystitis on the basis of the concentration of the bile pigments bilirubin and urobilin. In
ROYER M. BILIRUBIN AND UROBILIN CONTENT OF BILE OBTAINED BY DUODENAL DRAINAGE: NORMAL VALUES AND VALUES FOR PATIENTS WITH CHOLECYSTITIS. Arch Intern Med (Chic). 1939;64(3):445–456. doi:10.1001/archinte.1939.00190030038002
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