CASE HISTORY

There was a history of indigestion for 45 years, with occasional acute exacerbations of pain. The last attack had lasted a fortnight before admission to hospital. The direct X-ray  examination showed no evidence of a pathological gall-bladder, but cholecystography failed to visualise the gall-bladder. Cholecystectomy was performed by doctor and the gall bladder was found to contain 2 stones. Convalescence was uneventful.

PATHOLOGY

The specimen consists of the gall bladder removed at operation, opened to expose one large and one smaller stone, both probably "mixed" stones, the wall of the gall bladder is thickened and fibrosed and the mucous membrane is intensely congested. The serous coat shows some haemorrhages.