Summary Cholecystolithiasis - Definition, epidemiology, causes, riskfactors, diagnosis and treatment
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Course
3. Locomotor System
Institution
Maastricht University (UM)
In this summary you'll learn everything you need to know about Cholecystolithiasis. Everything about definition, epidemiology, causes, riskfactors, diagnosis and treatment. This is one of the disease that you need to know for the exam of the Cluster Locomotor System
Cholecystolithiasis
Definition
- The presence of gallstones in the gallbladder
- If the gallstones are in the common bile duct, it’s called choledocholithiasis
- Gallstones are hardened deposits of digestive fluid (e.g. bile)
- Bile consists of 70% bile salts and acids, 10% cholesterol, 5% phospholipids (e.g.
lecithin), 5% proteins, 1% bilirubin, and the rest are small amounts of water,
electrolytes (such as Ca2+) and bicarbonate
Epidemiology
- Prevalence: 10-15% of the adult population
- Mainly Native American and North America Indians
- Prevalence is higher in women than men
- The older, the higher the risk for gallstones
Morphology
- Gallstones range in size from as small as a grain of sand to as large as a golf ball
- Some people develop just one gallstone while others develop many at the same time
- There are 2 types of gallstones
o Cholesterol gallstones
This is the most common one (75-90% of cases) and often appears
yellow in color
They are mainly composed of undissolved cholesterol
When Ca2+ and bicarbonate combine, they form CaCO3 (calcium
carbonate) —> if this happens, the stones can be visible on an X-ray,
otherwise they cannot be seen
o Pigment/bilirubin gallstones
These appear dark brown or black in color
These mainly form when the bile contains too much bilirubin
Ca2+ and bilirubin combine, they form calciumbilirubinate —> since
they mainly consist of calcium, these are visible on an X-ray
98-99% of bilirubin in bile is conjugated, but 1-2% is unconjugated, BUT
bilirubin in pigment stones is unconjugated! (mechanism still unclear
why and how this happens)
Figure 1: Differences between the typs of gall stones. Source: Stinton, L. M., & Shaffer, E. A. (2012). Epidemiology of
gallbladder disease: cholelithiasis and cancer. Gut and liver, 6(2), 172–187. https://doi.org/10.5009/gnl.2012.6.2.172
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