Die Streptokokkenbesiedelung der Gallenwege

Rabl, Rudolf; Seelemann, M.

doi:10.1007/bf00955175

Cited by 4 publications

(1 citation statement)

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“…Darfiber hinaus konnte aber eine regelm~iBige Keimbesiedlung von Leber, Gallenblase und der H~.lfte der Gallenproben nachgewiesen werden. Eine solche hfimatogene Besiedlung der Gallenwege wurde nach intraven6ser Injektion von Streptokokken beschrieben [17]. Da die Keimbesiedlung der Gallenwege aber nicht ascendierend via Papilla Vateri erfolgt, sondern h~matogen fiber einen entero-hepatico-bilifiren Bakterienkreislauf aus dem Darm fiber Pfortader und Leber [8], ist ein Nachweis der Mikroorganismen in der Leber und der Gallenblasenwand eher m6glich.…”

Section: Diskussionunclassified

Experimentelle Gallensteinbildung. �tiologische Bedeutung von?-Glucuronidase-bildenden Bakterien und Gallenwegsobstruktionen

Hancke¹,

Marklein²

1983

Langenbecks Arch Chiv

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Bile pigment gallstones were produced in six of six mongrel dogs by narrowing the cystic duct with ligature after a postoperative interval of seven days. beta-Glucuronidase producing group G Streptococcus and Staphylococcus aureus were found in the bile, the gallbladder wall, and the liver. In another trial similar gallstones were produced in four of eight dogs after mere injection of beta-glucuronidase producing Escherichia coli into the spleen resp. in six of eight dogs after injection of E. coli into the colon without ligature of the cystic duct. In an additional series gallstones were produced in six dogs after injection of beta-glucuronidase producing E. coli into the colon plus ligature of the cystic duct. The injected strain of E. coli was found in the bile, the gallbladder wall, the liver, and even within the produced gallstones. In a control group in none of six dogs gallstones were present. beta-Glucuronidase producing group G Streptococcus was found in the gallbladder of one dog, Pseudomonas aeruginosa was found in the gallbladder of another dog and Staphylococcus aureus in the liver and gallbladder wall of a third dog. We conclude from our experiments that merely bacterial infection of the biliary tract can lead to gallstone formation. The bacterial colonization of the liver and the biliary tract is promoted by biliary tract obstruction. beta-Glucuronidase producing bacteria increase the amount of beta-glucuronidase in the bile thus leading to calcium bilirubinate precipitation and gallstone formation by deconjugation of bilirubindiglucuronide.

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Section: Diskussionunclassified