Studies on Non-Bacterial Cholecystitis. Protein Injection into Gall Bladder and Reaction of Gall Bladder in Anaphylaxis. ∗

Abstract

In spite of the previous failure to find a correlation between the nitrogen content of the gall bladder and cholecystitis, it was thought advisable to approach the matter experimentally by increasing the nitrogen content and observing the effects. This was done by the injection of egg albumen.

Fifteen dogs were operated upon. The egg albumen solutions used were first the undiluted white of egg and second, a 6% solution in Ringer's of crystalline purified egg albumen. They were injected either directly into the gall bladder cavity or into the wall. In 9 of the 15 cases the introduction was done by means of a needle puncture and in 4 cases a catheter was introduced into the gall bladder through an opening in the common duct and the material introduced through this. In some instances either the common or cystic duct was ligated and in others the gall bladder was allowed to remain patent. The amount of egg albumen solution used was 6 cc. in every instance. Before the introduction of this material 6 to 10 cc. of bile were aspirated from the gall bladder. When the injection was made into the wall of the gall bladder, 6 or 8 different spots were injected with about 1/2 cc. either subserously or into the deeper layers. The dogs were electrocuted in 48 hours and cultures and sediment tests of the bile made as well as microscopic examinations of the gall bladder.

Thirteen of the 15 gall bladders showed active recent inflammatory processes in the wall. These were characterized by edema, fibrinous exudate and hemorrhage. The gall bladder contained thick, deep green bile clouded with large bile-stained albumen flakes. Histologically, in all of the cases inflammatory reaction was present. This was much more pronounced in the outer layers. The most constant finding was a marked edematous thickening of the serosa with round cell infiltration which was not so marked. The lymphatics were often greatly dilated and fibrinous deposits in and over the serosa were frequent. The mucosa was normal while a minimal round cell infiltration was seen in the muscularis.