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Cholelithiasis & Cholecystitis
Gallstones form when certain substances harden in the gallbladder or bile ducts. Risk factors include family history, being a woman over 40, obesity, high-fat diet, and certain medical conditions. Gallstones can cause inflammation of the gallbladder, blockage of ducts, pancreatitis, and rarely cancer. Diagnosis involves ultrasound, blood tests, and endoscopy. Treatment is usually surgical removal of the gallbladder to prevent complications from gallstones.
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Cholelithiasis & Cholecystitis
- 1. cholelithiasis Prepared by Mr.Abhay Rajpoot HOD(Dep. of Medical Surgical) [email protected]
- 2. INTRODUCTION Gallstones arehardened deposits of digestive fluid that can form in the gallbladder. The gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath the liver. The gallbladder holds a digestive fluid called bile that's released into the small intestine. Gallstones range in size from as small as a grain of sand to as large as a golf ball. Some people develop just one gallstone, while others develop many gallstones at the same time
- 4. DEFINITION Gallstones are stonesor lumps that develop in the gallbladder or bile duct when certain substances harden. The gallbladder is a small sac located on the right-hand side of the body, on the underside of the liver.
- 6. RISK FACTOR • Havea family history of them • Are a woman • Are over age 40 • Are obese • Have a diet high in fat and cholesterol but low in fiber • Don’t get much exercise • Use birth control pills or hormone replacement therapy • Are pregnant • Have diabetes • Have an intestinal disease like Crohn’s • Have hemolytic anemia or cirrhosis of the liver • Take medicine to lower your cholesterol • Lose a lot of weight in a short time
- 7. CAUSES Too muchcholesterol. Normally, bile contains enough chemicals to dissolve the cholesterol excreted by the liver. But if liver excretes more cholesterol than your bile can dissolve, the excess cholesterol may form into crystals and eventually into stones. Bile contains too much bilirubin. Bilirubin is a chemical that's produced when the body breaks down red blood cells. Certain conditions cause your liver to make too much bilirubin, including liver cirrhosis, biliary tract infections and certain blood disorders. The excess bilirubin contributes to gallstone formation. Gallbladder doesn't empty correctly. If gallbladder doesn't empty completely or often enough, bile may become very concentrated, contributing to the formation of gallstones
- 8. TYPES OF GALLSTONES Typesof gallstones that can form in the gallbladder include: Cholesterol gallstones. The most common type of gallstone, called a cholesterol gallstone, often appears yellow in color. These gallstones are composed mainly of undissolved cholesterol, but may contain other components. Pigment gallstones. These dark brown or black stones form when your bile contains too much bilirubin
- 9. SIGN AND SYMPTOMS Sudden and rapidly intensifying pain in the upper right portion of your abdomen Sudden and rapidly intensifying pain in the center of your abdomen, just below your breastbone Back pain between your shoulder blades Pain in your right shoulder Nausea or vomiting
- 11. DIAGNOSTIC EVALUATION Physicalexamination History collection Abdominal ultrasound. This test is the one most commonly used to look for signs of gallstones. Abdominal ultrasound involves moving a device (transducer) back and forth across your stomach area. Endoscopic ultrasound (EUS). This procedure can help identify smaller stones that may be missed on an abdominal ultrasound. During EUS your doctor passes a thin, flexible tube (endoscope) through your mouth and through your digestive tract. Blood tests. Blood tests may reveal infection, jaundice, pancreatitis or other complications caused by gallstones.
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- 13. COMPLICATION Inflammation ofthe gallbladder. A gallstone that becomes lodged in the neck of the gallbladder can cause inflammation of the gallbladder (cholecystitis). Cholecystitis can cause severe pain and fever. Blockage of the common bile duct. Gallstones can block the tubes (ducts) through which bile flows from your gallbladder or liver to your small intestine. Severe pain, jaundice and bile duct infection can result. Blockage of the pancreatic duct. The pancreatic duct is a tube that runs from the pancreas and connects to the common bile duct just before entering the duodenum. Pancreatic juices, which aid in digestion, flow through the pancreatic duct.
- 14. A gallstonecan cause a blockage in the pancreatic duct, which can lead to inflammation of the pancreas (pancreatitis). Pancreatitis causes intense, constant abdominal pain and usually requires hospitalization. Gallbladder cancer. People with a history of gallstones have an increased risk of gallbladder cancer. But gallbladder cancer is very rare, so even though the risk of cancer is elevated, the likelihood of gallbladder cancer is still very small.
- 15. PREVENTION Don't skipmeals. Lose weight slowly. Eat more high-fiber foods. Maintain a healthy weight.
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