CHOLANGIOHEPATITIS OR RECURRENT PYOGENIC CHOLANGITIS WITH INTRAHEPATIC AND EXTRAHEPATIC BILE-PIGMENT STONES

While visiting surgical clinics in Japan and Hong Kong 2 years ago (1959) and again in 1960, I was impressed by the marked differences in the clinical and pathologic features of diseases of the biliary tract among the Japanese and among the Hong Kong Chinese from those of diseases of the same structures among patients of the United States. Although in some cases of recurrent pyogenic cholangitis (cholangiohepatitis) with and without bile-pigment ductal stones the symptoms are somewhat similar to those seen in Western people with chronic recurring cholecystitis, in other cases the difference is marked. In such cases there are crisis-like attacks of such severity that shock-like reactions develop quickly, and unless surgical decompression of the biliary tract is done immediately, the patient not infrequently dies. The clinical picture and the laboratory findings in these cases are so typical, according to McFadzean, that the diagnoses can be made readily