PERFORATION OF ACALCULOUS CHOLECYSTITIS ASSOCIATED WITH LOCALIZED ATHEROSCLEROSIS - REPORT OF A CASE

We describe herein the unusual case of a 68-year-old Japanese man who underwent laparotomy for an acute abdomen caused by diffuse peritoniti s, which revealed perforation of the gallbladder without any stones. A cholecystectomy was subsequently carried out, and histological examin ation showed marked atherosclerosis of the gallbladder associated ,vit h acute inflammatory changes. It is most likely that circulatory distu rbance of the gallbladder wall due to the atherosclerosis played an im portant role in the events leading to perforation. Acute acalculous ch olecystitis is an uncommon condition which is extremely difficult to d iagnose preoperatively. The clinicopathological features of this patie nt are of particular interest and importance in terms of pathogenesis as well as treatment.