[C] 1.37 Concretions (lithiasis) and pseudoconcretions

Question 1

Lithiasis & Calculus formation: Source of solid substances

Answer 1

• Secretions of certain organs
• Lined by mucous membranes

Question 2

Reasons for precipitation

Answer 2

• Increased concentration of crystalloids
• Decreased protective colloid content

Question 3

Microlith composition

Answer 3

Lithogenous material + Binding material

Question 4

Predisposing factors to concretions

Answer 4

1. Lithogenous material in increased amount
2. Inflammation of hollow organs
3. Stasis of excretions

Question 5

Lithogenous material in increased amount - Causes

Answer 5

• Metabolic disorders
• Nutritional factors

Question 6

Inflammation of hollow organs

Answer 6

• Changes in the pH
• Enzymatic destruction of the colloids
• Desquamation of the epithelial cells

Question 7

Sources of composition of different concretions: Calcium-carbonate

Answer 7

Food contaminated with limestone

Question 8

Sources of composition of different concretions: Phosphate calculi

Answer 8

Feeding with forage & bran

Question 9

Sources of composition of different concretions: Oxalate stones

Answer 9

High amount of fodder beet

Question 10

Sources of composition of different concretions: Cystine/xanthine stones

Answer 10

Metabolic disorders in urinary tract

Question 11

Concretion structure

Answer 11

• Microlith - Crystallisation centre
  
  • Foreign body, fibrin, necrotic cell
• Lithogenous material
  
  • Salts of organic or inorganic acids
  • Cholesterol, bilirubin, cystine, xanthine
• Binding material
  
  • Protein/mucous
• Concentric layering

Question 12

Concretion: Localisation

Answer 12

• Urinary tract
  
  • Renal pelvis & Urinary bladder
• Ducts of salivary gland
• Pancreatic duct
• Gallbladder
• Intestine
• Oral cavity - dental plaque

Question 13

Concretions in the large intestine of the horse

Answer 13

• Composition: Magnesium-ammonium-phosphate
• High amount of forage & bran - Magnesium(II) phosphate
• Putrefaction of proteins → NH₄ is produced

Question 14

A concretion formed in the salivary gland

Answer 14

Sialolith

Question 15

Give the fate of concretions in the body

Answer 15

• Small concretions exit the lumen
• Dissolve
• Break into smaller pieces
• Stay in the organ constantly

Question 16

Harmful effects of concretions

Answer 16

• Stenosis or complete obstruction of the lumen
• Mechanical trauma (Rough surface)
• Heavy stones - Pressure, atrophy & necrosis

Question 17

Pseudoconcretions

Answer 17

• Inspissation of content (dehydrating)
• Impaction of foreign materials

Question 18

Give the types of pseudoconcretion

Answer 18

1. Simple solidification of the excretions
2. Knotted animal hair (Zootrichobezoar)
3. Knotted plant elements (Phytotrichobezoar)
4. Conglobates

Question 19

Simple solidification of the excretions

Answer 19

• Fossae or the tonsils, prepuce, guttural pouch, bronchi & oviduct
• Secondary calcification

Question 20

Knotted animal hair

Answer 20

• Effect of the movements of the stomach (Ru, Sus, Ca)
• Bones, fur, fish-scale (in predators)

Question 21

Knotted plant elements

Answer 21

Straw, barley, chaff

In Eq & birds

Question 22

Conglobates

Answer 22

Undigested non-food fragments and foreign bodies

Question 23

Pseudoconcretions formed from eggs

Answer 23

Multifactoral disease

• The egg is stuck to the oviduct
• New eggs are also formed
• Abnormal decomposition of the egg starts
• Fibrin accumulated between the eggs
• Inflammation
• Wall of the oviduct gets reconstructed

Question 24

Consequences of concretions/pseudoconcretions

Answer 24

• Local irritation
• Pressure
  
  • Atrophy, necrosis & ulceration
• Narrowing & impacting the lumen of the organ
  
  • Painful spasm
  • Ileus
• Causing disorders of the passage
  
  • Obstruction & gas accumulation (tympany)