FN: Gallstones Flashcards Preview

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Flashcards in FN: Gallstones Deck (12):
1

Epi

1. 8% of the population >40yrs
2. Incidence increased over the last 20yrs: western diet
3. Slightly increased in females
4. 90% of gallstones remain asymptomatic

2

General composition

Phospholipids: ecithin
Bile pigments (broken down Hb)
Cholesterol

3

Aetiology

Lithogenic bile: Admirands triangle
Biliary sepsis
GB hypomotility --> stasis
. Pregnancy, OCP
--> TPN, fasting

4

Cholesterol stones: 20%

Large
Often solitary
Formation increases according to Admirands Trangle

5

Admirands triangle

Reduced bile salts
Reduced lecithin
Raised cholesterol

6

Risk Factors

Female
OCP, pregnancy
Age
High fat diet and obesity
Racial e.g. American Indian tribes
Loss of terminal ileum (reduced bil salts

7

Pigments stones: 5%

Small, black, gritty, fragile
Calcium bilirubinate
Associated w/ haemolysis

8

Mixed stones

Often mltiple
Cholesterol is the major componenet

9

Complications related to

Location:
1. In the Gallbladder
2. In the CBD
3. In the Gut

10

Gallbladder complications

1. Biliary Colic
2. Acute Cholecysitis ± empyema
3. Chronic cholecytsitis
4. Mucoecoele
5. Carcinoma
6. Mirizzis syndrome

11

In the CBD

Obstructive JAundice picture
Pancreatitis
Cholangitis

12

In the Gut

Gall stone ileus

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