Gallstones and biliary colic

Question 1

Why do gallstones form

Answer 1

due to increased cholesterol, decreased bile salts and biliary stasis

Question 2

What will a patient present with

Answer 2

-RUQ colicky pain
worse postprandially /after fatty foods

-Nausea
-Vomiting

Question 3

Risk factors for gallstones and biliary colic

Answer 3

-obesity
-female
-pregnancy
-40 plus
-Diabetes
-Crohn’s
-Rapid weight loss
-Drugs- fibrates, pill

Question 4

What investigations need to be ordered

Answer 4

-Abdominal ultrasound - identifies presence of gallstones

Bloods- FBC, CRP, bilirubin,LFT,serum lipase/amylase

Question 5

What other investigations can be ordered

Answer 5

-contrast enhanced CT or MRI if sepsis suspected

-blood cultures if septic

-MCRP if US doesnt detect CBD stones but bile duct is still dilated

-Endoscopic ultrasound if MRCP does not lead to diagnosis

Question 6

What is the management

Answer 6

Bile duct clearance and laparoscopic cholecystectomy

Question 7

Risk factors of gallbladder disease

Answer 7

5 F’s
fair, fat, female ,fertile and forty