GANGRENE AND PERFORATION OF THE WALL OF THE GALLBLADDER

Abstract
Almost a century ago (1844), James Duncan,1surgeon at the Royal Infirmary in Edinburgh, reported an instance of gangrene of the gallbladder which had ruptured, producing peritonitis, followed by death. The diagnosis was made at autopsy. In 1933, Dr. Samuel A. Vest Jr.,2of Baltimore, collected the reported cases of gangrenous cholecystitis; a total of 71 were gleaned from the literature, and 9 were reported as new. Twenty-three of the 80 patients died as a result of the condition—a mortality rate of 37 per cent. Gangrene of a portion of the entire wall of the gallbladder is, we believe, a sequela of acute cholecystitis and frequently leads to perforation. By "gangrene of the wall of the gallbladder" we refer to complete necrosis of a portion of the wall in one or more areas; we do not use the term to indicate gangrene of the entire gallbladder. Our reason

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