c

 


 c

  
or Gallstones
Mass of crystallized substances that forms in the
gallbladder. The most common type occurs when
the liver secretes bile with too much cholesterol to
stay in solution. Liver damage, chronic
gallbladder disease, or biliary-tract cancer may
predispose one to stone formation. In the
gallbladder, stones may cause inflammation or
produce no symptoms. A stone obstructing the
bile duct causes severe pain (biliary colic).
Gallstones usually must be removed
with the gallbladder or broken up with
ultrasound. In some cases a stone can
be treated by giving the patient bile
salts, which help redissolve cholesterol.
If the gallbladder must be removed,
laparoscopy is the method of choice.
 


pidemiologic data are available from a number
of large uropean and American populations.
These studies have revealed a marked variation
in overall gallstone prevalence between different
ethnic populations. As a general rule, there
appears to be higher rates of cholelithiasis in
western Caucasian, Hispanic, and Native
American populations and lower rates in eastern
uropean, African American, and Japanese
populations
In the United States, the age standardized
prevalence of gallbladder disease was
estimated based upon a sample of more
than 14,000 persons aged 20 to 74 in
whom gallbladder disease was detected by
the presence of gallstones or
cholecystectomy on ultrasonography. The
following prevalence rates were observed:
V.6 and 16.6 percent among non-
Hispanic white men and women,
respectively
V.9 and 26.7 percent among Mexican
American men and women, respectively
5.3 percent and 13.9 percent among
non-Hispanic black men and women,
respectively
 
 


  

 Ë The majority of people who
have gallstones do not have symptoms; their
stones remain "silent." Silent gallstones are often
found on an ultrasound or CT scan done for other
reasons. Silent stones do not need to be treated
since the first symptoms of gallstones are usually
mild and there are risks involved in removing the
gallbladder.
If you have silent gallstones, you should be
aware of the initial symptoms of gallstone
disease because you will need treatment quickly
if you develop symptoms
m  
 Ë iliary colic, also known as gallstone
pain or biliary pain, is the most common symptom of
gallstones. It causes attacks of abdominal pain, often
located in the right upper belly just under the lower ribs.
You may also feel nausea, and vomiting, and pain in the
right shoulder or back.
iliary colic usually happens when the gallbladder
contracts in response to a fatty meal. This compresses
the stones, blocking the opening. As the gallbladder
relaxes several hours after the meal, the pain subsides.
Once you have a first attack of biliary colic, there is a
good chance you will have more severe symptoms in the
future.
  
 Ë Acute cholecystitis refers to
inflammation of the gallbladder. It happens when
there is a complete blockage of the gallbladder,
caused by repeated episodes of biliary colic. Unlike
biliary colic, which resolves within a few hours, pain is
constant with acute cholecystitis and fever is
common.
Acute cholecystitis is a serious condition that requires
immediate medical treatment in the hospital.
Treatment includes IV fluids, pain medicine, and
sometimes, antibiotics. Surgery to remove the
gallbladder is usually recommended during the
hospitalization or shortly thereafter. If not treated,
acute cholecystitis can lead to gallbladder rupture, a
life-threatening condition.




 c
 


Gallstones that do not cause symptoms rarely lead to
problems. Death, even from gallstones with symptoms,
is very rare. Serious complications are also rare. If they
do occur, complications usually develop from stones in
the bile duct, or after surgery.
Gallstones, however, can cause obstruction at any
point along the ducts that carry bile. In such cases,
symptoms can develop.
In most cases of obstruction, the stones block the
cystic duct, which leads from the gallbladder to the
common bile duct. This can cause pain (O
 
),
infection and inflammation ( 

  ), or both.
About 10% of patients with symptomatic gallstones also
have stones that pass into and obstruct the common
bile duct (




 ).
c
 


  

 Ë Complications
can develop if gallstones move and block the area
where bile exits (a condition known as
choledocholithiasis).
Jaundice is a yellow discoloration of the skin and
eyes.
Acute cholangitis is an infection of the bile ducts
that causes pain, chills, and fever. This requires
prompt treatment, usually involving removal of the
gallstone with a non-surgical procedure known as
endoscopic retrograde cholangiopancreatography,
or 
CP. (endoscopic retrograde
cholangiopancreatography)
Acute pancreatitis is sudden inflammation of the
pancreas, leading to severe abdominal pain.
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Õood enters the stomach from the esophagus at the at the
  and passes into the stomach. In the fasting state the
stomach is kept in a state of contraction, but the presence
of food causes it to expand. The    of the stomach are
folds in the mucosa seen in the fasting state, unlike the
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The surface for absorption is increased in many
ways: the mucosa of the small intestine is thrown
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epithelial cells are also covered with numerous
projections called 
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appearance of a 'brush' on light microscopy, hence
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the rectum and anus. The microscopic appearance is
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feces are formed. These are propelled forwards by a form of
movement called   

. The colon is populated
with bacteria, which usually operate in a symbiotic mode.
Any food that has not been processed may be digested by
these bacteria, and the products will then be absorbed by
the Large Intestine.

The feces are now passed to the rectum where they await
elimination. The process of elimination is controlled by two
sphincters, the Internal and external Anal sphincters. The
former is under involuntary control, the latter under
voluntary control.
 

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