Cholelithiasis (gallstones)

Abdomen | Gastroenterology | Cholelithiasis (gallstones) (Disease)


Cholelithiasis also called gallstones is crystalline solidification formed inside the gallbladder due to accumulation of bile components.

Gallstones come in three varieties: cholesterol stones - vary in color from light-yellow to dark-green or brown and are oval 2 to 3 cm in length, often having a tiny dark central spot; pigment stones are small, dark stones made of bilirubin and calcium salts; and mixed gallstones.

Symptoms that may occur include: pain in the right upper or middle upper abdomen, fever, yellowing of skin and whites of the eyes, condition called jaundice, clay-colored stools, nausea and vomiting. Blockage of the cystic duct or common bile duct by gallstones may cause complications like: acute cholecystitis; cholangitis; cholecystitis - chronic; choledocholithiasis and pancreatitis.

Causes and Risk factors

The calculi are due to accumulation of bile components and form in the gallbladder, but may pass distally into other parts of the biliary tract such as the cystic duct, common bile duct, or pancreatic duct.

Increase risk of developing gallstones is represented by the following conditions: bone marrow or solid organ transplant, diabetes, failure of the gallbladder to empty bile properly, liver cirrhosis and biliary tract infections, medical conditions that cause the liver to make too much bilirubin, such as chronic hemolytic anemia, including sickle cell anemia, rapid weight loss from eating a very low-calorie diet, or after bariatric surgery and receiving nutrition through a vein for a long period of time (intravenous feedings).

Diagnosis and Treatment

Diagnosis is confirmed after the following investigation: blood test (bilirubin level, liver enzyme levels, liver function tests, white blood count) and medical imaging (abdominal ultrasound, endoscopic retrograde cholangiopancreatography (ERCP), magnetic resonance cholangiopancreatography (MRCP), percutaneous transhepatic cholangiogram (PTCA).

Treatment can be either medical or surgical, involving the gallbladder removal also known as Cholecystectomy. ...

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