16286              RECURRENT CHRONIC CHOLECYSTITIS

This patient was a man aged 78 who lived alone and drank heavily.  He was admitted with pitting oedema of the ankles and sacrum which was thought to be a possible consequence of thiamine deficiency.  He died of broncho-pneumonia and pyelonephritis.

The specimen consists of the biliary apparatus with portions of the liver and duodenum together with the pancreas.  The gallbladder is about normal in size but the wall is thick and fibrous.  The mucosa is trabeculated and shows mild patchy inflammation. At postmortem it contained thin pus.  The cystic duct is obstructed but the common bile duct is narrow and patent.  The pancreas shows some fatty infiltration and a few flecks of fat necrosis.  The duodenum is congested.  A single large mixed pigment and cholesterol stone was present in the lumen.  Histology shows pus in the lumen and chronic sclerosing inflammatory changes in the wall, with many mononuclear phagocytes.