18 Gallstones
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- bilirubin for heme elimination
- bile salts for fat absorption
- cholesterol for cholesterol elimination
- all 3 needed in balance to not have stones
- also need phosphatidylcholine
Cholesterol Stones
- either increased levels of cholesterol or decreased levels of bile acids and phosphatidylcholine
Risks
Bilirubin Stones
- infections: convert to unconjugated, less soluble
- hemolysis/liver disease: black
Gallbladder Symptoms
- removal of gallbladder main way to treat stones
Biliary Colic
Acute Cholecystitis
- US: wall of gallbladder thickened
Choledocolithiasis
Gallstone Pancreatitis
Chronic Cholecystitis
- inflammation > Ca deposition > porcelain gallbladder
Acalculous cholecystitis
Bile Duct Symptoms
AIDS Cholangiopathy
Ascending
- clonorchis: looks like cholangitis but with eosinophilia. Recently ate sushi/fish
- take picture and extract stones
Gallstone Ileus
- fistula between gallbladder and intestine
- nl: never air in biliary tree
Gallbladder Carcinoma
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