Gallstones

What are the complications of gallstones? In this tutorial you will learn how to answer this question, and you'll learn a little bit about the clinical features and aspects of management for all the problems those pesky stones can cause. More tutorials at www.boxmedicine.com.  

Acute Cholecystitis This is caused by a blockage in the cystic duct or neck of the gallbladder (95% of cases are gallstones or gallstone precursor ‘sludge’) It is unlikely to be infection, and more likely to be local inflammation. You can also get associated peritonitis.  

Gallstones and biliary disease can be a bit confusing, and there is a lot of overlap. Essentially, gallstones themselves are not problematic in the vast majority of cases, but can predispose the other problems with the biliary tree.   Gallstones  

Surgery is the only definitive treatment and is recommended for people with symptomatic gallstones who are fit to undergo surgery  

Surgery is the only definitive treatment and is recommended for people with symptomatic gallstones who are fit to undergo surgery  

Surgery is the only definitive treatment and is recommended for people with symptomatic gallstones who are fit to undergo surgery  

Surgery is the only definitive treatment and is recommended for people with symptomatic gallstones who are fit to undergo surgery  

Surgery is the only definitive treatment and is recommended for people with symptomatic gallstones who are fit to undergo surgery  

In a lecture today, someone said today that a patient might still get gallstones even after they've had their gallbladder removed. I don't get how! Can someone explain please?  

An obese 63 year old lady presents with jaundice. There is no history of abdominal pain. Examination of her abdomen reveals a palpable gall bladder. There is evidence of extensive pruritis. She tells you she drinks 42 units of alcohol a week. Her blood results are as follows: Albumin 32 (35-50) Alk Phos 456 (<110) ALT 88 (<40) Bilirubin 120 (<20) INR 1.6 GGT 400 (0-70) What’s the most likely diagnosis? a. Gallstones b. Paracetamol Overdose c. Pancreatic cancer d. Alcoholic Hepatitis e. Primary billiary cirrhosis  

Diet high in fat may reduce the risk of gallstones during rapid weight loss: http://www.nutrientsreview.com/lipids/fats.html Diet high in saturated fat may increase the risk of gallstones. Meals high in fat supposedly trigger pain in gallbladder stones disease, and many doctors recommend low-fat meals to prevent the pain http://www.patient.co.uk/health/gallstones-diet-sheet My questions: Do high-fat meals really trigger pain in gallbladder stone disease? Any experience with patients? Would you, as a doctor, recommend a low-fat diet to someone who already has gallstones?  

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Ultrasound is indicated in the first 24 hours, mainly to identify gallstones as the cause of pancreatitis rather than to contribute to the diagnosis  

All patients with acute pancreatitis should have liver function tests and abdominal ultrasonography within 24 hours of admission to look for gallstones  

Surgery is the only definitive treatment and is recommended for people with symptomatic gallstones who are fit to undergo surgery  

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One recently published prospective cross-sectional study (Villar et al., 2015) suggested simplifying the definition of a positive POCUS test to be presence of gallstones alone. With the simplified definition in evaluating for acute cholecystitis, POCUS had a sensitivity of 100% and NPV 100%. In other words, absence of gallstones alone rules out acute cholecystitis. [1]  

Is coffee consumption related to a decreased risk of gallstone disease?  

The abdominal x-rays show dilated small bowel loops with air fluid levels. The erect abdominal x-ray, on close examination shows air in the biliary tree. There are multiple rounded irregular densities in the mid abdomen (turned out to be calcified mesenteric lymph nodes on CT). This patient likely has a small bowel obstruction secondary to gall stone.  

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The application of the recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.