Gallstones/Gallbladder Disease

Question 1

What are the two most common disorders related to

the gallbladder?

Answer 1

1. Inflammation 2. Obstruction
   McCance KL, Huether SE. Pathophysiology: The Biologic
   Basis for Disease in Adults and Children. Maryland Heights,
   MO: Mosby Elsevier; 2010: 1494.

Question 2

Define the difference between cholecystitis and

cholelithiasis.

Answer 2

Cholecystitis is the inflammation of the cystic duct or
gallbladder, whereas cholelithiasis is the formation of gallstones.
McCance KL, Huether SE. Pathophysiology: The Biologic
Basis for Disease in Adults and Children. Maryland Heights,
MO: Mosby Elsevier; 2010: 1494.

Question 3

List risk factors associated with the development of

cholelithiasis.

Answer 3

Middle age; obesity; female gender; rapid weight loss by obese
individuals; oral contraceptive use; high dietary cholesterol;
pancreatic, ileal, or gallbladder disease, and being of American
Indian descent.
McCance KL, Huether SE. Pathophysiology: The Biologic
Basis for Disease in Adults and Children. Maryland Heights,
MO: Mosby Elsevier; 2010: 1495.

Question 4

What are the two most common types of gallstones?

Answer 4

Cholesterol and pigmented. Cholesterol stones occur most
frequently. Pigmented stones are seen less frequently, are
associated with cirrhosis, and occur later in life.
McCance KL, Huether SE. Pathophysiology: The Biologic
Basis for Disease in Adults and Children. Maryland Heights,
MO: Mosby Elsevier; 2010: 1494.

Question 5

What are the hallmark manifestations of

cholelithiasis?

Answer 5

Fatty food intolerance and right upper quadrant pain
McCance KL, Huether SE. Pathophysiology: The Biologic
Basis for Disease in Adults and Children. Maryland Heights,
MO: Mosby Elsevier; 2010: 1495.

Question 6

What are the more ambiguous symptoms associated

with cholelithiasis?

Answer 6

Flatulence, heartburn, jaundice, pruritus, epigastric discomfort,
food intolerance (mostly seen with the consumption of fats and
cabbage)
McCance KL, Huether SE. Pathophysiology: The Biologic
Basis for Disease in Adults and Children. Maryland Heights,
MO: Mosby Elsevier; 2010: 1495.

Question 7

What is the treatment of choice for patients with

cholelithiasis due to inflammation or obstruction?

Answer 7

Laparoscopic cholecystectomy
McCance KL, Huether SE. Pathophysiology: The Biologic
Basis for Disease in Adults and Children. Maryland Heights,
MO: Mosby Elsevier; 2010: 1495.

Question 8

1. What is the term for pain caused from

cholelithiasis? 2. What causes this pain?

Answer 8

1. Biliary colic 2. The pain occurs from gallstones becoming
   lodged in the common bile duct or cystic duct.
   McCance KL, Huether SE. Pathophysiology: The Biologic
   Basis for Disease in Adults and Children. Maryland Heights,
   MO: Mosby Elsevier; 2010: 1495.

Question 9

A patient will cholelithiasis exhibits jaundice. Where

would you expect the gallstone to be located?

Answer 9

Common bile duct
McCance KL, Huether SE. Pathophysiology: The Biologic
Basis for Disease in Adults and Children. Maryland Heights,
MO: Mosby Elsevier; 2010: 1495.

Question 10

Where does pain often radiate in patients with

symptomatic cholelithiasis?

Answer 10

Pain often radiates to the mid-upper back.
McCance KL, Huether SE. Pathophysiology: The Biologic
Basis for Disease in Adults and Children. Maryland Heights,
MO: Mosby Elsevier; 2010: 1495.

Question 11

What is the most common cause of cholecystitis?

Answer 11

The most common cause of cholecystitis occurs from one or
more gallstones that become lodged in the cystic duct. The
gallbladder becomes distended and inflamed as a result of this
obstruction.
McCance KL, Huether SE. Pathophysiology: The Biologic
Basis for Disease in Adults and Children. Maryland Heights,
MO: Mosby Elsevier; 2010: 1495.

Question 12

What are the symptoms associated with

cholecystitis?

Answer 12

Pain that resembles cholelithiasis, leukocytosis, fever,
abdominal muscle guarding, and rebound tenderness.
McCance KL, Huether SE. Pathophysiology: The Biologic
Basis for Disease in Adults and Children. Maryland Heights,
MO: Mosby Elsevier; 2010: 1495.

Question 13

What two tests can confirm a diagnosis of

cholecystitis?

Answer 13

Radioactive scan or cholangiography
McCance KL, Huether SE. Pathophysiology: The Biologic
Basis for Disease in Adults and Children. Maryland Heights,
MO: Mosby Elsevier; 2010: 1495.

Question 14

What are the mainstays of the medical management

of cholecystitis?

Answer 14

Fluid and electrolyte replacement, fasting, pain control, and
antibiotics in severe cases.
McCance KL, Huether SE. Pathophysiology: The Biologic
Basis for Disease in Adults and Children. Maryland Heights,
MO: Mosby Elsevier; 2010: 1495.

Question 15

What occurs when pressure builds against the
distended wall of the gallbladder? What are the
possible outcomes of this situation?

Answer 15

When pressure builds against the distended wall of the
gallbladder, there is a decrease in blood flow. This can result in
necrosis, ischemia, and gallbladder perforation.
McCance KL, Huether SE. Pathophysiology: The Biologic
Basis for Disease in Adults and Children. Maryland Heights,
MO: Mosby Elsevier; 2010: 1495.