Cholelithiasis

Question 1

Function of the gallbladder?

Answer 1

Stores and concentrates bile

Question 2

Where is bile produced?

Answer 2

By the liver

Question 3

Cholelithiasis?

Answer 3

Precipitation of bile content -> stone formation (aka gallstones)

Question 4

Etiology of cholelithiasis?

Answer 4

• Genetic predisposition
• Increased precipitate in the bile (abnormal bile components)
• Bile stasis

Question 5

What does bile contain?

Answer 5

• NaHCO2 -> neutralizes chime
• Bile salts -> breakdown fat
• Lecithin -> transports fat
• Cholesterol -> for excretion
• Bilirubin -> waste product of heme breakdown -> excreted

Question 6

When does the issue arise with stones?

Answer 6

The gall bladder can be almost entirely full of stones with no complications. The issue arises when the stones migrate out of the Gall bladder

Question 7

Types of gallstones?

Answer 7

• cholesterol stones (80%)
• pigment stones (20%)
• mixed stones

Question 8

What do cholesterol stones contain?

Answer 8

Bile and excess cholesterol

Question 9

What do pigment stones contain?

Answer 9

Bilirubin and calcium salts

Question 10

Manifestations of cholelithiasis?

Answer 10

• Asymptomatic if they remain in the gallbladder
• If stones migrate they can lead to obstructions. These obstructions lead to: colicky intermittent pain d/t stones migrating, nausea & vomiting d/t severe pain.
• May possibly be confused with a UTI

Question 11

Diagnostics for cholelithiasis?

Answer 11

Ultrasound to visualize stones in the gall bladder and pick up duct obstructions. CT if US is not revealing.

Question 12

Treatment for cholelithiasis?

Answer 12

• Pain management
• Dissolving agents (drugs that tend to break up the stone)
• Surgery

Question 13

If you have a stone blocking a major duct in the system, you can have a rupture. What are possible complications that can arise?

Answer 13

• Pancreatitis
• Perforation
• Cholecystitis