Gallstones

Question 1

Aetiologies?

Answer 1

Cholesterol stones - hyperlipidaemia, old age, females, pregnancy, rapid weight loss
Pigment/mixed - haemolysis, infection, cirrhosis
Smoking a risk factor for both

Question 2

Pathology?

Answer 2

Stones form from excess cholesterol or stasis of bile

Question 3

Signs and Symptoms?

Answer 3

Asymptomatic, many found incidentally

Acute onset biliary pain radiating to tip of scapula

Question 4

Investigations and Findings?

Answer 4

USS - primary investigation, stones visualised

ERCP/MRCP also used

Question 5

Management?

Answer 5

Incidental stones left
Oral bile acid supplements
Cholecystectomy and sphincteroctomy

Question 6

Complications?

Answer 6

Cholecystitis infection