ACUTE EMPHYSEMATOUS cholecystitis is an uncommon disease which was first reported by Welch and Flexner1 in 1896 as an autopsy finding, the causative organism was Bacillus aerogenes capsulatus (Clostridium perfringens). Stolz2 in 1901 described gas in the gallbladder and biliary ducts as an autopsy finding in three patients. Lobinger3 in 1908 found gas in the gallbladder lumen associated with intramural gas in a patient who was operated on for acute cholecystitis. The first roentgenographic findings were described by von Friederich4 in 1929, and Hegner5 in 1931 made the first reported roentgenographic diagnosis in the US by describing the circumferential layer of gas in the gallbladder wall.
Edinburgh and Geffen6 in 1958 reviewed 49 cases published in the world literature and added one of their own. Among these 50 patients, the incidence of diabetes was 24% and that of biliary calculi was 80%. Marshall and