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April 1956

Acute Pneumocholecystitis: A Review and Report of Two Cases

Author Affiliations

Highland Park, III.; Hines, III.
From the Surgical Service, VA Hospital, Hines, Ill., and Surgical Service, Highland Park, Ill.; Instructor in Surgery, Research and Educational Hospital, Attending Surgeon, VA Hospital, Hines, Ill. (Dr. Olander); Resident in General Surgery, VA Hospital, Hines, Ill. (Dr. Bowman).

AMA Arch Surg. 1956;72(4):709-714. doi:10.1001/archsurg.1956.01270220157020

Acute pneumocholecystitis or acute gaseous cholecystitis is a descriptive term for an acutely inflamed and sometimes gangrenous gall bladder whose lumen contains air. Occasionally it is characterized by pericholecystic air infiltration. Pyopneumocholecystitis is characterized by a fluid level. Similar to cholecystitis, with or without cholelithiasis, the pathogenesis of pneumocholecystitis is a decrease in the local resistance of the gall-bladder wall, which allows a previously avirulent gas-producing organism to become virulent and results in growth of the organism in the wall and within the gall bladder. Production of gas follows within the lumen of the gall bladder. The mechanism whereby gas infiltrates the pericholecystic tissue is not definitely established. There are two theories. One assumption is that air, initially in the lumen, finds its way into the pericholecystic tissues by way of local areas of necrosis in the mucosa and submucosa owing to the virulent inflammatory process. The other conception is