Cholelithiasis

  • Treatment of gallstone disease
  • A bile stone disease is a disease in which there is a formation of stones in the gall bladder and less in the bile ducts.
    Etiology. Hereditary predisposition is of some importance; the disease occurs in many members of the same family, especially among women, in different generations. Plays the role of over-nutrition. The disease is more common in women in old age. In the pathogenesis of lithogenic have a value of three factors: infringement of metabolism, the stagnation of bile and infection. The emergence of stagnation can determine the anatomical changes in the biliary tract, functional disorders associated with irregular meals, and neurogenic factors. In the result of metabolic disorders reduces the level of bile acids in the bile, normally prevents the deposition of cholesterol from the bile into the sediment. Infection and related inflammation play a leading role in the formation, as the disintegrating epithelium of the gallbladder is a source of cholesterol, and from inflammatory exudate appears lime is the second part of the stones.
    Pathological anatomy. There are three stages in the development of a bile stone disease: I stage - bladder wall infiltrated lipids, stones are missing; II stage - microlithiasis (sand); stage III - shaped stones in the gall bladder l occurrence of complications associated with them. Inflammation may precede the formation or consistently develops as a complication.
    The clinical picture. The main symptom of the disease - attack of pain in the right hypochondrium, a so-called hepatic colic. Pain can be of different intensity. Iradionet pain right up and backwards (under the blade, collarbone). The duration of pain variable (from several hours to several days). Painful attack may be accompanied by rise of temperature up to subfebrile and feverish digits, nausea, vomiting. Vomiting not ease the pain, unlike ulcer disease. Sometimes bloating, time delay urination, aetiology. With the protracted attack sometimes appears jaundice, which is becoming resistant when hardening zhelchevyvodjashchih (common bile) duct stone. Provoke the attack of biliary colic fatty food, taking alcohol, shaky riding, hypothermia, fatigue, heavy exercise and other Pain causes spasm of smooth muscles of the gallbladder and bile ducts. The disease is extremely varied: in some cases, the attacks are frequent, others are rare, sometimes with long breaks.
    Complications. 1. Obstruction of the neck of the gallbladder or the cystic duct leading to the development of dropsy of the gallbladder, which becomes available palpation. In a secondary infection in the revised bubble appear febrile temperature and high leukocytosis. 2. Corking zhelchevyvodjashchih duct is accompanied by mechanical jaundice (see). Experiencing itching, aetiology. Liver function tests have not changed. Due to the stagnation of bile from the liver increases, the bladder is not felt in that case, if the walls are changed inflammation and lost the ability to stretch. Corking zhelchevyvodjashchih duct accompanied by the attack of biliary colic, then the pain subside. Can an infectious process in bile passages - cholangitis (see), followed undulating fever. For jaundice is associated with promotion of the stone in the gall passages.
    The diagnosis of a bile stone disease is based on the colics, detection of stones on chest x-ray, and sometimes only on the basis of such complications, as dropsy of the gallbladder and mechanical jaundice. The prognosis depends on the frequency of attacks of a bile stone disease, presence of complications.