Gallstones Flashcards
What are gallstones?
Gallstones (cholelithiasis) refers to the formation of hard stones in the gallbladder – a process which typically takes years to occur. It is a very common phenomenon which affects about 10-15% of the general population in the developed world.
What is the second most common organ that requires surgery in the GI tract?
Gallbladder
What does bile contain?
- Bile pigments (from Hb breakdown products)
- Cholesterol
- Other lipids
What are the 3 types of gallstones?
- Cholesterol stones
- Pigment stones
- Mix of both
75% of which type of gallstones in the USA and Europe?
Cholesterol
What are the clinical features of pure cholesterol stones?
- Usually solitary and large
- Risk factors = Female, age and obesity
Stones of about 70% or more of cholesterol are usually smaller and more numerous. The rest of the stone is made up of calcium compounds and protein.
What are the clinical features of mixed gallstones?
Usually multiple and irregular shaped
What two categorises can pigment stones be categorised into?
- Brown
- Black
What are brown mixed stones like?
Soft and contain a mixture of pigment, cholesterol and calcium salts
What are black mixed stones like?
Black stones are hard and made up of pure pigment
Why are females at greater risk of gallstones?
oestrogen and progesterone impair gallbladder emptying
What causes the formation of cholesterol and mixed stones? (2)
1) stasis
2) supersaturation of cholesterol
What are black pigment stones comprised of? (3)
1) polymerised calcium bilirubinate
2) calcium phosphate
3) calcium carbonate
Describe the appearance of black pigment stones (3):
1) small
2) hard
3) brittle
What causes the formation of black pigment gallstones? (2)
1) stasis
2) supersaturation of bilirubin