[Gangrenous cholecystitis without lithiasis. A report on a case diagnosed by simple radiography of the abdomen (author's transl)].

The authors report a case of gangrenous cholecystitis without lithiasis but with secondary infection of the gallbladder by anaerobic germs. Pre-operative diagnosis was possible from simple x-rays of the abdomen which demonstrated an obvious fluid level in the gallbladder, and by parietography. An immediate cholecystectomy was performed. Bacteriological examination of the bile confirmed the presence of Clostridium perfringens. The main bile duct appeared normal and the bile in the common bile duct was sterile. Convalescence was uneventful with antibiotic cover, in spite of the age and condition of the patient. Gangrenous cholecystitis occurs more frequently without gallbladder stones in humans. Clinical signs are not specific but simple x-rays of the abdomen are pathognomonic and enable pre-operative diagnosis to be made. Urgent cholecystectomy appears to be the ideal treatment. This affection has a high mortality and early operation is therefore justified.