Gall Stones

Question 1

What are the risks factors for gall stones?

Answer 1

Fat

Fair (caucasion)

Female

Fertile (over 1 kid)

Forty - Over 40

Question 2

What can the presence of gall stones cause?

Answer 2

1. Acute cholecystitis
2. Biliary colic
3. Ascending cholangitis
4. Pancreatitis

Plus:

• Empyema
• Mirizzi syndrome
• Mucocele
• Gallstone ileus

Question 3

1. What is biliary colic?
2. What are the symptoms?
3. What are the investigations?
4. What is the management?

Answer 3

1. Gallstone in bile duct
2. Causing acute severe pain in RUQ and central +/-jaundice, Can be worse with food
3. US, bloods plus amylase, Erect chest and supine abdo
4. Analgesia, NBM and fluids to see if settles. Cholecystecomy if recurrent

Question 4

What is acute cholecystitis?

What are the symptoms?

What would you see on examination?

What are the investigations?

What is the treatment?

Answer 4

Stone impacting the neck of the bladder

RUQ pain, nausea and vomiting, local peritonism

Murphys sign, signs of infection

Full bloods including amylase (Raised WCC), obstructive jaundice, US shows inflammation. ?Xray

NBM, antibiotics, fluid, analgesia ?cholecystectomy