Gallstones – Part 3
October 24, 2009 by
Filed under Gall Bladder Symptoms
Gall stones are of 3 types
1.Pure cholestrol stones-forming 10% of gall stones.
2.Mixed stones- composed of cholestrol , bile pigments and calcium accounting for 90% of gall stones.
3.Pigment stones.
Risk factors for cholestrol stones include:
1.female gender
2.obesity
3.exogenous estrogens
4.increasing age(mostly above 40)
5.diabetes
6.pregnancy
7.rapid weight loss.
risk factors for pigment stones:
1.hemolytic anemias
2.ileal resection or disease
3.biliary tract infection
4.bile stasis.
The cholestrol stones develop when the bile is supersaturated with cholestrol as compared to bile salts because bile salts and phospholipids make the cholestrol soluble in the bile.So if the bile salts are reduced the cholestrol is precipitated and forms gall stones.
Similarly the unconjugated bilirubin is insoluble in bile and precipitates to form gall stones in case of hemolytic anemias.
The signs and symptoms include:
1.about 80% of the gall stones are asymptomatic.
2.acute cholecystitis
3.biliary colic.
Complications:
1.acute cholecystitis.
2.chronic cholecystitis.
3.gall stone ileus.
4.gall bladder empyema(pus in gall bladder)
5.mucocele of the gall bladder(collection of serous fluid in gall bladder)
6.gangrene of the gall bladder.
7.Porcelein gall bladder.
The investigation of choice is ultrasound of gall bladder.
Treatmeant:
1.Cholecystectomy.
2.dissolution of gall stones-in chenodeoxycholic acid and ursodeoxycholic acid.
3.Lithotripsy
5.
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