Gallstone

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Gallstone
Synonyms	Cholelith
Pronounce	N/A
Specialty	N/A
Symptoms	Abdominal pain, nausea, vomiting, jaundice
Complications	Cholecystitis, pancreatitis, cholangitis
Onset	Middle age
Duration	Variable
Types	N/A
Causes	Cholesterol stones, bilirubin stones
Risks	Obesity, pregnancy, diabetes, cirrhosis, Crohn's disease
Diagnosis	Ultrasound, CT scan, MRI
Differential diagnosis	Peptic ulcer disease, pancreatitis, hepatitis
Prevention	Healthy diet, maintaining a healthy weight
Treatment	Cholecystectomy, ursodeoxycholic acid
Medication	Pain management, antibiotics
Prognosis	N/A
Frequency	Common
Deaths	Rare

Gallstones are hard, pebble-like deposits that form within the gallbladder or bile ducts. These stones can range in size from as small as a grain of sand to as large as a golf ball. Gallstones are primarily composed of cholesterol, bile, and/or calcium salts.

File:Gallstones.JPG

Gallstones

File:Ultrasonography of sludge and gallstones, annotated.svg

Ultrasonography of sludge and gallstones, annotated

Causes and Types

Gallstones form when there is an imbalance in the substances that make up bile. The two main types of gallstones are cholesterol stones and pigment stones.

• Cholesterol stones: These are the most common type of gallstones, making up about 80% of all gallstones. They form when the liver excretes more cholesterol than the bile can dissolve.
• Pigment stones: These are smaller, darker stones made of bilirubin, a byproduct of red blood cells broken down by the liver. Pigment stones can occur when there are certain medical conditions, such as liver cirrhosis or blood disorders, that lead to increased production of bilirubin.

Symptoms

While many people with gallstones do not have any symptoms (known as "silent gallstones"), some may experience symptoms when a gallstone lodges in a duct and causes a blockage. These symptoms, often referred to as a gallstone attack or biliary colic, can include:

• Severe pain in the upper right abdomen or in the center of the abdomen, just below the breastbone
• Back pain between the shoulder blades
• Pain in the right shoulder
• Nausea or vomiting

Diagnosis

Gallstones are often found during routine imaging tests for other conditions. If gallstones are suspected, the following diagnostic tests may be used:

• Ultrasound: This is the most common test for gallstones. It uses sound waves to create images of the gallbladder and bile ducts.
• Computed tomography (CT) scan: This can provide detailed images of the gallbladder and surrounding organs.
• Magnetic resonance cholangiopancreatography (MRCP): This test uses magnetic fields and radio waves to create detailed images of the bile ducts, pancreas, and gallbladder.

Treatment

Treatment depends on whether the gallstones are causing symptoms. Silent gallstones are usually left untreated. If gallstones are causing symptoms, treatment options can include:

• Cholecystectomy: This is surgery to remove the gallbladder, and it is the most common treatment for symptomatic gallstones.
• Medications: Certain medications can be used to dissolve gallstones, but they may take months or years to work, and the stones may return once treatment is stopped.
• Endoscopic retrograde cholangiopancreatography (ERCP): This procedure is used to remove gallstones in the bile duct.

See Also

• Gallbladder
• Bile Ducts
• Cholecystitis
• Cholecystectomy