Gallstones and Biliary Colic Flashcards
What is the primary function of the gallbladder?
Stores bile and sends it to the small intestine to emulsify fat
What are the main components of bile?
Bile salts + acids (70%), cholesterol (10%), phospholipids/proteins/bilirubin
What triggers the gallbladder to contract and secrete bile?
Fatty meal –> CCK secreted –> gallbladder contracts and bile is secretedinto dudenum
What are the three types of gallstones?
- Cholesterol stones (yellow)
- Bilirubin (pigmented) stones
- Brown stones (infective cause)
What characterizes cholesterol stones?
Yellow, caused by supersaturation, not enough salts/acids, and gallbladder stasis
What are pigment stones composed of?
Cholesterol (25%) + calcium bilirubinate
What is the appearance of pigment stones?
Black, crumbly, small
What type of gallstones are the most common?
Mixed stones
What factors increase the risk of developing gallstones?
- Female
- Asian population
- Obesity
- High fatty food intake
- Diabetes mellitus
- Family history
- Hemolytic anemia
- Pregnancy
- Age
What is biliary colic?
Impaction of gallstones in gallbladder neck forming a mucocele
What are the 4F’s associated with the risk of biliary colic?
- Fat
- Female
- Forty
- Fertile
What symptoms are associated with biliary colic?
- Dull pain in Epigastric/RUQ
- Pain radiates to shoulder/back
- Pain after eating (fatty meals)
- Nausea/Vomiting
Describe the pain felt in biliary colic?
Colickey pain: sharp, localized pain that comes and goes in waves, often caused by spasms or obstructions
How is biliary colic diagnosed?
Based on recurrent symptoms and confirmed by ultrasound
What is the primary treatment for biliary colic?
- Pain management
- Surgery: Cholecystectomy
What signs are typically observed in patients with biliary colic?
Generally well, RUQ tenderness
What imaging technique is used to identify gallstones?
Ultrasound (USS)
What dietary changes are recommended for managing gallstones?
Low fatty meals
What happens to the gallbladder appearance in imaging when gallstones are present?
Gallbladder looks normal (thin walled) except for gallstones
