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Mario M. Y. I.
(03011177)
DEFINITION
ETIOLOGY
Cholesterol gallstones
Pigment gallstones
EPIDIMIOLOGY
PATHOLOGY
Cholesterol gallstones
The first is an abnormally rapid formation and growth of cholesterol particles into gallstones.
Thus, with the same concentrations of cholesterol, bile acids and lecithin in their bile, patients
with gallstones form particles of cholesterol more rapidly than individuals without gallstones.
The second process that promotes the formation and growth of gallstones is reduced contraction
and emptying of the gallbladder that allows bile to stay in the gallbladder longer than normal so
that there is more time for cholesterol particles to form and grow.
Pigment gallstones
Black pigment gallstones
If there is too much bilirubin in bile, the bilirubin combines with other constituents in bile, for
example,calcium, to form pigment (so-called because it is dark brown in color). Pigment
dissolves poorly in bile and, like cholesterol, it sticks together and forms particles that grow in
size and eventually form gallstones. The pigment gallstones that form in this manner are called
black pigment gallstones because they are black and hard.
Brown
pigment gallstones
If there is reduced contraction of the gallbladder or obstruction to the flow of bile through the
ducts, bacteria may ascend from theduodenuminto the bile ducts and gallbladder. The bacteria
alter the bilirubin in the ducts and gallbladder, and the altered bilirubin then combines with
calcium to form pigment. The pigment then combines with fats in bile (cholesterol andfatty
acids from lecithin) to form particles that grow into gallstones. This type of gallstone is called a
brown pigment gallstone because it is more brown than black. It also is softer than black pigment
gallstones.
SYMPTOMATHOLGY
Biliary colic
Constant pain
15 minutes to 4-5 hours
Nausea
DIAGNOSIS
TREATMENT
Cholecystectomy
Oral dissolution therapy
CONCLUSION