What Are Gallstones?

Gallstones (commonly misspelled gall stones or gall stone) are solid particles
that form from bile cholesterol and bilirubin in the gallbladder.

 The gallbladder is a small saclike organ in the upper right part of the
abdomen. It is located under the liver, just below the front rib cage on
the right side.
 The gallbladder is part of the biliary system, which includes the liver and
the pancreas.
 The biliary system, among other functions, transports bile and digestive
enzymes.

There are two types of gallstones: 1) cholesterol stones and 2) pigment

stones.

1. Patients with cholesterol stones are more common in the United

States; cholesterol stones make up a majority of all gallstones. They
form when there is too much cholesterol in the bile.
2. Pigment stones form when there is excess bilirubin in the bile.
 Gallstones Causes
Gallstones occur when bile forms solid particles (stones) in the gallbladder.

 The stones form when the amount of cholesterol or bilirubin in the bile is
high.
 Other substances in the bile may promote the formation of stones.
 Pigment stones form most often in people with liver disease or blood
disease, who have high levels of bilirubin.
 Poor muscle tone may keep the gallbladder from emptying completely.
The presence of residual bile may promote the formation of gallstones.

• ‫تتشكل الحجارة عندما تكون كمية الكوليسترول أو البيليروبين مرتفعة‬.

• ‫المواد األخرى في الصفراء قد تشجع على تكوين الحجارة‬.

• ‫ والذين‬، ‫تتشكل حصوات الصباغ في معظم األحيان في األشخاص الذين يعانون من أمراض الكبد أو أمراض الدم‬

‫لديهم مستويات عالية من البيليروبين‬.

• ‫ وجود الصفراء المتبقية قد تعزز تشكيل حصوات‬.‫قد تمنع نغمة العضالت الضعيفة المرارة من التفريغ تما ًما‬

‫المرارة‬

What Are the Symptoms of Gallstones?

 May be silent.
 May be severe and sudden pain in the upper right abdomen and possibly extending to
the upper back.
 Tachycardia.
 Diaphoresis.
 Occurs usually 3-6 hours post meals.
 Obstructive Jaundice (yellowing of the skin or eyes)
 Pruritus.
 Clay colored stools or dark urine.
 Intolerance to fatty food.
 Fever and shivering.
 Severe nausea and vomiting.
• ‫قد تكون صامتة‬.
• ‫قد يكون األلم شديدًا ومفاجئًا في الجزء العلوي األيمن من البطن وربما يمتد إلى أعلى الظهر‬.
• ‫عدم انتظام دقات القلب‬.
• ‫تعرق غزير‬.
• ‫ ساعات بعد الوجبات‬6-3 ‫يحدث عادة بعد‬.
• ‫)اليرقان االنسدادي (اصفرار الجلد أو العينين‬
• ‫الحكة‬.
• ‫طين البراز الملون أو البول الداكن‬.
• ‫عدم تحمل الطعام الدهني‬.
• ‫الحمى واالرتعاش‬.
• ‫الغثيان الشديد والقيء‬.

Risk factors for the formation of cholesterol gallstones include the following:

 female gender,
 being overweight,
 losing a lot of weight quickly on a "crash" or starvation diet, or
 taking certain medications such as birth control pills or cholesterol
lowering drugs.

Complications:
However, gallstones can sometimes cause complications, such as:
 inflammation of the gallbladder (cholecystitis);
 inflammation of the bile duct (cholangitis);
 inflammation of the pancreas (biliary pancreatitis);
 obstruction of the intestine (gallstone ileus) ;
‫‪‬‬ ‫; ‪Biliary cirrhosis‬‬
‫‪‬‬ ‫; ‪Carcinoma‬‬
‫‪‬‬ ‫‪Peritonitis.‬‬
‫‪‬‬
‫التهاب المرارة (التهاب المرارة) ؛ •‬

‫التهاب القناة الصفراوية (التهاب األقنية الصفراوية) ؛ •‬

‫التهاب البنكرياس (التهاب البنكرياس الصفراوي) ؛ •‬

‫انسداد األمعاء (حصاة حصاة) ؛ •‬

‫•‬ ‫التشمع الصفراوي ؛‬

‫سرطان ؛ •‬

‫‪.‬الصفاق •‬

‫‪Diagnosis‬‬


Endoscopic retrograde cholangiopancreatography (ERCP)

Tests and procedures used to diagnose gallstones include:

 Tests to create pictures of your gallbladder.Your doctor may recommend an
abdominal ultrasound and a computerized tomography (CT) scan to create
pictures of your gallbladder. These images can be analyzed to look for signs of
gallstones.

 Tests to check your bile ducts for gallstones. A test that uses a special dye to
highlight your bile ducts on images may help your doctor determine whether a
gallstone is causing a blockage.

Tests may include a hepatobiliary iminodiacetic acid (HIDA) scan, magnetic

resonance imaging (MRI) or endoscopic retrograde cholangiopancreatography
(ERCP). Gallstones discovered using ERCP can be removed during the
procedure.

 Blood tests to look for complications. Blood tests may reveal an infection,
jaundice, pancreatitis or other complications caused by gallstones.

Treatment

 Surgery to remove the gallbladder (cholecystectomy). Your doctor may

recommend surgery to remove your gallbladder, since gallstones frequently recur.
Once your gallbladder is removed, bile flows directly from your liver into your small
intestine, rather than being stored in your gallbladder.

You don't need your gallbladder to live, and gallbladder removal doesn't affect your
ability to digest food, but it can cause diarrhea, which is usually temporary.

 Medications to dissolve gallstones. Medications you take by mouth may help

dissolve gallstones. But it may take months or years of treatment to dissolve your
gallstones in this way and gallstones will likely form again if treatment is stopped.

Sometimes medications don't work. Medications for gallstones aren't commonly

used and are reserved for people who can't undergo surgery.