Cholelithiasis (Gallstones)

Question 1

Cholelithiasis epidemiology?

Answer 1

most commonly seen in obese, multiparous women over the age of 40

Question 2

Cholelithiasis what types of stones?

Answer 2

1. Cholesterol stones
2. Pigment stones
3. Mixed stones

Question 3

Cholesterol stones associated with?

Answer 3

obesity, 
older age, 
Crohn disease, 
cystic fibrosis, multiparity,
rapid weight loss, clofibrate use, estrogen use,

Question 4

Pigment stones associated with?

Answer 4

alcoholic cirrhosis, hemolytic anemia, biliary tract infection, and
older age

Question 5

Cholelithiasis pathogenesis?

Answer 5

Stones form when cholesterol and bilirubin overwhelm solubilizing bile acids
and lecithin in the gallbladder

Question 6

cholesterol stones fx?

Answer 6

Radiolucent, although 10%−20% may be opaque owing to calcification

Question 7

pigment stones fx?

Answer 7

Radio-opaque; composed of bile pigments

Question 8

Mixed stones fx?

Answer 8

Radiolucent; composed of both cholesterol and bile pigments; most common type

Question 9

Cholelithiasis clinical signs?

Answer 9

Usually asymptomatic,

may present with
1. Charcot triad:

2. severe colicky epigastric and RUQ pain (especially after fatty meal),
3. spiking fever
4. jaundice

Question 10

Cholelithiasis complications?

Answer 10

1. biliary colic,
2. common bile duct obstruction,
3. cholecystitis,
4. acute pancreatitis,
5. gallstone ileus,
6. ascending cholangitis,
7. possible adenocarcinoma of the gallbladder

Question 11

Cholelithiasis treatment?

Answer 11

Cholecystectomy if symptomatic; no treatment if asymptomatic