A Study of Gallstones

Paper Summary:

In this article, the writer notes that gallstones are the commonest biliary pathology, more prevalent in Western countries. The writer points out that although a gallstone is asymptomatic in the majority, it can cause significant morbidity and mortality if left untreated. A variety of imaging modalities are performed to accurately diagnose the condition. The writer notes that there are a variety of both surgical and medical methods of treatment. In this study the writer explores the typical conditions of this disorder. Further, the writer looks at the various investigations and treatment modalities, as well reviews the complications and prognosis of the condition.

Outline:
Introduction
Prevalence
Ethnic And Genetic predisposition
Age
Obesity
Other Factors
Pathogenesis
Relationship of sludge to gallstones
Clinical Features
Atypical clinical features
Investigations
Management of Gallstone Disease
Complications and Prognosis
Summary
Conclusion

From the Paper:

"Gallstones are more common in obese, fertile women. The high-risk populations include Pima Indians in Arizona, Scandinavians, American Indian groups in Alaska, Canada, Bolivia and Chile. The common risk factors for developing gallstones are increasing age, obesity, and cholesterol hypersecretion. Gallstones are classified into cholesterol stones, mixed stones, and pigment stones. Although gallstones are asymptomatic in upto 75% of patients, they may become symptomatic by either causing obstruction to the cystic duct or common bile duct. The most characteristic symptom is biliary colic. The other clinical features are acute cholecystitis, choledocholithiasis, and cholangitis. The atypical clinical features include emphysematous cholecystitis, and small bowel obstruction. The investigations performed for gallstones include a routine haemogram, liver function tests, blood culture, serum amylase, imaging studies, oral cholecystography, Computed Tomographic Cholangiography and Magnetic Resonance, ERCP, and cholescintigraphy."

Sample of Sources Used:

• Bortoff GA (2000). Gall bladder stones: Imaging & Intervention. Radiographics, 2000. 20:751.
• Benniger G et al (1992). Piezoelectrische Lithotripsie von gall blasensteiner. Dtsch Med Wochen Schr, 1992. 117; 1350.
• Clavier PA et al (1990). Gallstone ileus. Br J Surg, 1990. 77:737.
• Dumont AE (1976). Significance of hyperbilirubinemia in acute cholecystitis. Surg Gynecol Obstet, 1976. 142:855.
• Egbert AM (1990). Gallstone symptoms: Myths and reality. Postgrad Med :119, 199.)

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