Cholelithiasis

Question 1

What is it?

Answer 1

Gallstones

Question 2

What is it made is it of?

Answer 2

Cholesterol and Pigment

Question 3

Risk factors?

Answer 3

• Age
• Female
• Parity ( number of pregnancies brought to conclusion)
• Use of the oral contraceptive pill
• Obesity
• Pigment diseases e.g. hemolytic anaemia/bile infection

Fat, female, forty, fertile,fair

Question 4

Causes for increase of cholesterol in the body?

Answer 4

• obesity
• Cirrohsis
• Ileal disease
• cystic fibrosis

Question 5

Causes for increase of pigment in the body?

Answer 5

• haemolytic anemia

- bile infection

Question 6

Presentation

Answer 6

• asymptomatic
• Biliary colic- when gallstones from the gall bladder block the common bile duct
• Dyspepsia- problems swallowing
• Nausea
• Vomiting
• Empyema
• perforation
• Jaundice (Mirrizi syndrome)
• Obstruction of the small bowel- Gallstone Ileum (when they get stuck in neck of ileum)
• Acute Cholecystitis- inflammation of the gallbladder

Question 7

Treatment?

Answer 7

• Dissolution / Lithotrypsy (uses ultrasound waves)

- Laparoscopic Cholecystectomy (open/mini/laparoscopic/single port)

Question 8

choledocho-lithiasis

Answer 8

Stones which form/ collect in the bile duct

Differential diagnosis for cholethiasis

Question 9

Mirrizi syndrome

Answer 9

When gallstones get stuck in the neck of the gallbladder leading to obstruction Jaundice

Question 10

Investigations

Answer 10

Amylase, Lipase: will be elevated
AUS
LFT- elevated alkaline phosphatase when complicated.
FBC- WBC elevated in complicated cholelithiasis
-Oral Cholecystography
-IV cholangiography