lelithiasis, is one of the most common surgical problems worldwide.
They are a frequent cause of abdominal
pain and dyspepsia.
Pathophysiology
Although gallstones can form anywhere in the biliary tree, the most common point of origin is within the gallbladder. There are 3 types of gallstones, pure cholesterol, pure pigment, and mixed. Under normal conditions, a delicate balance occurs among the levels of bile acids, cholesterol, and phospholipids. A disparity in this balance, especially with the supersaturation of cholesterol, predisposes patients to the formation of lithogenic bile and the subsequent development of cholesterol-type gallstones. Pigmented gallstones are composed of calcium bilirubinate and appear in 2 major forms, black and brown. Hemolysis and liver disease are associated with the black stones; the brown, earthy stones more frequently are formed outside the gallbladder and often are associated with bacterial infections of the biliary tract. Bile stasis predisposes to the formation of biliary sludge and eventual formation of gallstones and commonly is seen in patients who are unable to take enteral nutrition. Infection of the biliary tree (especially with certain beta-glucuronidase-producing bacteria, such as Escherichia coli and parasites) is associated with an increased risk of ductal stone development. Intestinal resection is associated with an increased incidence of gallstones. Contrary to expectation, these are mainly of the pigment variety. Women are more likely to develop gallstones than men, with a ratio of 2:1. Classically, gallstones occur in obese, middle-aged women leading to the popular mnemonic, fat, fertile, forties. Oral contraceptive pills with high estrogen content increase the incidence of gallstones. The incidence increases with age
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patient has 21mm large calculus is noted in the neck of gallbladder. was reported during Ultra sound scan reported by Radiologist. With mild prostatomegaly and fattyliver.Ask to do surgery looking for Altirior Medicine to avoid surgery. mahendra_khanted Saturday, July 30, 2011
can you please show pictures on how a gall stone look outside rosariomoral Thursday, April 16, 2009 Ask an Expert C If you have a question about health related issues, you can now post it in our Ask An Expert section on our community website Medwonders.com and get answers from our panel of experts. Cholelithiasis s Pathophysiology s Clinical Features s Investigations s Treatment CME Lessons A Diagnostic approach to ProteinuriaA Focused approach to AnemiaAbdominal PainAbdominal pain in womenAbnormal Vaginal BleedingAcid Peptic DiseaseAcute evaluation and management of ischemic stroke-1Acute Respiratory infections in ChildrenAcute sinusitisAdult immunizationsAmbulatory Management of BurnsAn Introduction to Biomedical EthicsAnorectal ExaminationApproach to Breast LumpsApproach to the Somatizing PatientApproach to VaginitisCannot Miss DiagnosisCervical CancerChest PainChildhood EpilepsyCholelithiasisCommon Bed Side ProceduresConjunctivitisConstipation in ChildrenDermatologicDiagnosis and Management of Alcohol ProblemsDiarrhea in ChildrenEmergency Thora CentesisEndometriosisEvaluation of headacheFebrile SeizuresFever in ChildrenHead Ache in ChildrenHeamorrhoidsHematuriaImmunization in ChildrenIncision and Drainage of abscessInfective EndocarditisIntraosseous Fluid InfusionIntroduction to DermatologyLaboratory Evaluation of the patient with jaundiceLeprosyLeukocytosisLow Back PainMalariaManagement of Heart FailureManaging Pshychiatric disorders in Primary CareMeningitis in ChildrenObstructed Femoral HerniaOverview of the risk factors for cardiovascular diseasePerforated Peptic UlcerPericardio CentesisPhimosisPremenstrual syndromePreoperative medical evaluation of the healthy patientPressure UlcersPrimary DysmenorrheaRecurrent Abdominal PainSchool Problems and the Family PhysicianSkin InfectionsSomatoform DisordersStroke-IThe Crying Infant Pleural EffusionTuberculosis in ChildrenUrinary Incontinence in WomenUrinary tract infectionUrinary Tract Infection in the Paediatric Patient 4 Family Medicine Comments Pharma AlendronateAmitriptylineCelecoxibClonazepamDanazolDiphenhydramineEpinephrineFerrous SulphateGlibenclamideHydroxyzineLoperamideMetforminOmeprazoleOxybutyninOctreotide AcetatePioglitazone HydrochloridPropranololRanitidineRosiglitazone MaleateSilver sulfadiazineSucralfateSumatriptanValproic AcidAcarboseSpironolactone What's New on Medindia
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