INFECTION IN CHRONIC CHOLECYSTITIS

Abstract

The diagnosis of biliary tract infection by nonoperative means remains a practical clinical problem, notwithstanding improvements in diagnostic procedures. The fact that the duodenum is normally sterile and that bacteria of the biliary tract can be obtained with a duodenal tube has been known for many years.¹ Duodenal cultures consistent with those found in the biliary tract at operation can be obtained with an encapsulated duodenal tube.² Duodenal cultures, however, are influenced by the presence of free hydrochloric acid in the gastric contents because the free acid apparently has an inhibiting effect on the growth of bacteria in the stomach, duodenum and bile.³ Cultures of the liver may be positive for pathogenic organisms in the normal person because some bacteria transmitted by the blood stream to the liver to be destroyed may survive. These are excreted into the bile ducts. There, however, they rarely produce pathologic changes