Hospital admissions for acute cholecystitis: changes in the age and sex distribution in Oxford in the post-war period.

Admissions for acute cholecystitis to the Radcliffe Infirmary, Oxford, during the period 1974-1978 have been reviewed and compared with figures previously published for the period 1953-1962 (1). There was a small overall increase in the annual rate of female admissions for acute cholecystitis between the two periods and this increase can be accounted for by population changes in all age groups above the age of 40 years. However, there was a significant increase in the admission rate of women under the age of 40 which could not be accounted for by changes in population alone. This apparent increase in acute gallbladder disease in young women coincides with the growth between 1960 and 1970 of the number of women taking oral contraceptives, and is further evidence of a causal relationship between the use of the contraceptive pill and the development of gallstones. Women taking oral contraceptive steroids had a higher rate of common bile duct exploration and of sphincteroplasty than did those not taking oral contraceptives. The annual rate of male admissions almost doubled between the two periods and this increase cannot be accounted for by population changes. There has also been a virtual disappearance of acute cholecystitis in children over the same time.