Gall stones Flashcards
Job of gallbladder
To store bile
What does bile do
Emulsifies fat in the small intestine so it is easier to absorb
Composition of bile
70% bile salts/acids, 10% cholesterol, 5% phosphlipids, 5% proteins, 1% conjugated (and very very small amount of unconjugated) bilirubin, water, electrolytes and bicarbonate
Two types of gall stone
Cholesterol stones and bilirubin (pigmented) stone
Most common type of gallstone
Cholesterol stones
3 ways in which cholesterol stones precipitate out of bile
Supersaturation of cholesterol, lack of bile salts/acids and gallbladder stasis (bile stationary)
Which stone is more visible on an X-ray
Bilirubin stone
Describe bilirubin stones
When too much unconjugated bilirubin is present it binds to calcium ions to form calcium bilirubin and this precipitates out of bile.
What are brown stones a sign of
Infection such as E.coli
What are the 4fs
Fat, female, forty, fertile
What are risk factors for gallstones
Oral contraceptives, obesity and rapid weight loss
Diagnosis
US is gold standard
Treatment
IV antibiotics/fluids and urgent cholecystectomy
What is biliary colic
Stone impacts in cystic duct that causes gradual build up of pain in RUQ that radiates to the back and may last 2-6 hours.
What is gallstone ileus
Gallstones impacted in distal ileum and causes a distal small bowel obstruction
