TY - JOUR T1 - A review of abdominal surgery AU - NAGEL GW, JUDD E, PARKER BR, BUEERMANN WH, PEIPER HH Y1 - 1929/09/01 N1 - 10.1001/archsurg.1929.01150030161010 JO - Archives of Surgery SP - 526 EP - 566 VL - 19 IS - 3 N2 - GALLBLADDER  Moynihan1 found that infection began in the outer coats of the gallbladder in 63 of 81 cases of cholecystitis. In 18, the inner coats were primarily involved. Infection may reach the outer coats by direct extension from the liver, by means of the lymphatics communicating directly between the liver and gallbladder or by involvement of the peritoneal surface as a consequence of disease in an adjacent organ. In cases of infection from within, the ascending route is followed more frequently than is realized. Cholecystitis as a rule is only a part of an infection which has its origin elsewhere. Hepatitis is commonly, if not always, present, and is almost certainly of earlier origin than the inflammation of the gallbladder. Moynihan stated that sufficient regard has not been paid to the spleen as an infective agent. In some cases with recurrent stones and with marked infection in the common SN - 0272-5533 M3 - doi: 10.1001/archsurg.1929.01150030161010 UR - http://dx.doi.org/10.1001/archsurg.1929.01150030161010 ER -