FN: Gallstones Flashcards
1
Q
Epi
A
- 8% of the population >40yrs
- Incidence increased over the last 20yrs: western diet
- Slightly increased in females
- 90% of gallstones remain asymptomatic
2
Q
General composition
A
Phospholipids: ecithin
Bile pigments (broken down Hb)
Cholesterol
3
Q
Aetiology
A
Lithogenic bile: Admirands triangle Biliary sepsis GB hypomotility --> stasis . Pregnancy, OCP --> TPN, fasting
4
Q
Cholesterol stones: 20%
A
Large
Often solitary
Formation increases according to Admirands Trangle
5
Q
Admirands triangle
A
Reduced bile salts
Reduced lecithin
Raised cholesterol
6
Q
Risk Factors
A
Female OCP, pregnancy Age High fat diet and obesity Racial e.g. American Indian tribes Loss of terminal ileum (reduced bil salts
7
Q
Pigments stones: 5%
A
Small, black, gritty, fragile
Calcium bilirubinate
Associated w/ haemolysis
8
Q
Mixed stones
A
Often mltiple
Cholesterol is the major componenet
9
Q
Complications related to
A
Location:
- In the Gallbladder
- In the CBD
- In the Gut
10
Q
Gallbladder complications
A
- Biliary Colic
- Acute Cholecysitis ± empyema
- Chronic cholecytsitis
- Mucoecoele
- Carcinoma
- Mirizzis syndrome
11
Q
In the CBD
A
Obstructive JAundice picture
Pancreatitis
Cholangitis
12
Q
In the Gut
A
Gall stone ileus
