Cholelithiasis

Cholelithiasis is the formation of stones (gallstones) in the gallbladder.

General

• Often accompanies cholecystitis/contributes and/or causes cholecystitis.
• The gallbladder is removed following biliary pancreatitis (gallstone pancreatitis) to reduce recurrence risk.
• Gallstones may compress the common bile duct - known as Mirizzi syndrome.
  • Can be associated with jaundice.

The two types of gallstones:

• Cholesterol stones.
• Pigment stones.

Note:

• Most stones technically speaking are a mix, i.e. cholesterol and pigment. Many call yellow stones that are a mix "cholesterol stones".

Epidemiology

Classic risk factors for gallstones - 4 Fs:

• Female.
• Fat.
• Forty.
• Fertile.

Additional:

• Family history.

Cholesterol stones

• More common than pigment stone.

Appearance:

• Clear or yellow.
• Opaque or translucent.
• Sometimes shinny.

Image

• 

  Yellow gallstones. (WC)

Pigment stones

• Due to high RBC turnover, e.g. sickle cell disease, thalassemia.
• Radio-opaque.

Appearance:

• Black - key feature.
• Dull.

Microscopic

• Not routinely done on gallstones.

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GALLBLADDER CHOLECYSTECTOMY:
- CHOLELITHIASIS.
- MILD CHRONIC CHOLECYSTITIS.

See also

• Gallbladder.
• Kidney stones.