Your SlideShare is downloading. ×
0
Presented by :  H. Al-Buainain Supervised : Prof. Parashar PATHOGENESIS OF  GALLSTONES
Introduction <ul><li>Anatomy “ liver lobules” . </li></ul><ul><li>Bile synthesis . </li></ul><ul><li>Role of bile acid . <...
<ul><li>Liver is largest & most important metabolic Organ in the body . </li></ul><ul><li>One of its importance function t...
Liver Lobule
<ul><li>Bile acid  </li></ul><ul><li>Cholesterol </li></ul><ul><li>Phospholipid  </li></ul><ul><li>Bilirubin </li></ul>Com...
Cholesterol Metabolism <ul><li>Cholesterol is an extremely important molecules in : </li></ul><ul><li>- membrane structure...
SYNTHESIS OF CHOLESTEROL <ul><li>Less than half of the cholesterol is derived from denovo . </li></ul><ul><li>10 % of chol...
Synthesis of Cholesterol
<ul><li>So End product of cholesterol  utilization are bile acid </li></ul>Chenodeoxycholic acid cholic acid Glycine or Ta...
Bilirubin synthesis
<ul><li>Adult human produce 400 – 800 ml of bile daily . </li></ul><ul><li>BILE SECRETION : </li></ul><ul><li>Occur in two...
Role of Bile In Fat Digestion   Absorption <ul><li>Bile acids are Amphipathic </li></ul>
<ul><li>It is enable bile acid to carry out to important functions : </li></ul><ul><li>- Emulsification of lipid aggregate...
Emulsification
Role Of Bile Acid In Cholesterol    Homeostasis <ul><li>In human , 500 mg of cholesterol are converted to bile acids . </l...
ENTEROHEPATIC  CIRCULATION
CONTROL OF BILE SECRETION <ul><li>Bile secretion regulated by : </li></ul><ul><li>Cholecystokinin </li></ul><ul><li>Secret...
SIGNIFICANCE OF BILE   ACID <ul><li>Bile acid play 4 physiological function: </li></ul><ul><li>1- Elimination of excess ch...
<ul><li>It is one of the digestive disorder . </li></ul><ul><li>more common in females . </li></ul><ul><li>Classified acco...
<ul><li>It is the commonest type of G.stones </li></ul><ul><li>mainly d/t : </li></ul><ul><ul><li>Abnormality in liver syn...
Cholesterol Gallstones  Formation <ul><li>formation of gall stones  pass through 3 processes :  </li></ul>
Risk factors Gallstones    Formation
Types of Cholesterol stones <ul><li>There are two types:  </li></ul>90-100% Solitary , Whitish > 2.5 cm 50 - 90% Multiple ...
PIGMENTED GALLSTONES - Calcium bilirubinate - Ca Soap - Bacteria has role in the synthesis - >  in Asia  - Mainly at bile ...
<ul><li>Asymptomatic . </li></ul><ul><li>Biliary cholic . </li></ul><ul><li>Calcular cholecystitis . </li></ul><ul><li>Cho...
Conclusion <ul><li>The bile play a major role in the excretion of cholesterol & absorption of fat sol Vit.  </li></ul><ul>...
THANK YOU
Upcoming SlideShare
Loading in...5
×

Gallstone

7,135

Published on

Published in: Health & Medicine
1 Comment
3 Likes
Statistics
Notes
No Downloads
Views
Total Views
7,135
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
378
Comments
1
Likes
3
Embeds 0
No embeds

No notes for slide

Transcript of "Gallstone"

  1. 1. Presented by : H. Al-Buainain Supervised : Prof. Parashar PATHOGENESIS OF GALLSTONES
  2. 2. Introduction <ul><li>Anatomy “ liver lobules” . </li></ul><ul><li>Bile synthesis . </li></ul><ul><li>Role of bile acid . </li></ul><ul><li>Clinical significance of bile . </li></ul><ul><li>Gallstone </li></ul>
  3. 3. <ul><li>Liver is largest & most important metabolic Organ in the body . </li></ul><ul><li>One of its importance function to the digestive system is synthesis & secretion of bile . </li></ul>ANATOMY
  4. 4. Liver Lobule
  5. 5. <ul><li>Bile acid </li></ul><ul><li>Cholesterol </li></ul><ul><li>Phospholipid </li></ul><ul><li>Bilirubin </li></ul>Composition of Bile
  6. 6. Cholesterol Metabolism <ul><li>Cholesterol is an extremely important molecules in : </li></ul><ul><li>- membrane structure </li></ul><ul><li>- Precursor of Steroid Hormone </li></ul><ul><li>and bile acids. </li></ul>
  7. 7. SYNTHESIS OF CHOLESTEROL <ul><li>Less than half of the cholesterol is derived from denovo . </li></ul><ul><li>10 % of cholesterol are synthesized in the liver while 15 % from SI. </li></ul>
  8. 8. Synthesis of Cholesterol
  9. 9. <ul><li>So End product of cholesterol utilization are bile acid </li></ul>Chenodeoxycholic acid cholic acid Glycine or Taurine Glycocholic Acid Taurocolic Acid
  10. 10. Bilirubin synthesis
  11. 11. <ul><li>Adult human produce 400 – 800 ml of bile daily . </li></ul><ul><li>BILE SECRETION : </li></ul><ul><li>Occur in two stages : </li></ul><ul><li>1- Active secretion from hepatocytes to the canaliculi , bile duct . </li></ul><ul><li>2- Modification in the bile duct through addition of H2O & HCO3 </li></ul><ul><li>During fasting state , bile will be stored in the gallbladder . </li></ul>
  12. 12. Role of Bile In Fat Digestion Absorption <ul><li>Bile acids are Amphipathic </li></ul>
  13. 13. <ul><li>It is enable bile acid to carry out to important functions : </li></ul><ul><li>- Emulsification of lipid aggregates </li></ul><ul><li>- Solubilization & transport of lipid in </li></ul><ul><li>aqueous enviroment . </li></ul>
  14. 14. Emulsification
  15. 15. Role Of Bile Acid In Cholesterol Homeostasis <ul><li>In human , 500 mg of cholesterol are converted to bile acids . </li></ul><ul><li>This route will eliminate excess amount of cholesterol . </li></ul>
  16. 16. ENTEROHEPATIC CIRCULATION
  17. 17. CONTROL OF BILE SECRETION <ul><li>Bile secretion regulated by : </li></ul><ul><li>Cholecystokinin </li></ul><ul><li>Secretin </li></ul>- Bile salt
  18. 18. SIGNIFICANCE OF BILE ACID <ul><li>Bile acid play 4 physiological function: </li></ul><ul><li>1- Elimination of excess cholesterol. </li></ul><ul><li>2- Solubilize cholesterol which prevent </li></ul><ul><li>PPT in the GB . </li></ul><ul><li>3- Facilitate digestion of TG through </li></ul><ul><li>emulsification . </li></ul><ul><li>4- Facilitate absorption of fat soluble </li></ul><ul><li>vitamines. </li></ul>
  19. 19. <ul><li>It is one of the digestive disorder . </li></ul><ul><li>more common in females . </li></ul><ul><li>Classified according to the chemical composition into : </li></ul><ul><li>- Cholesterol . </li></ul><ul><li>- Pigment . </li></ul><ul><li>- Calcium . </li></ul><ul><li>Each type has particular pathophysiology </li></ul><ul><li>and special risk factors . </li></ul>GALLSTONES
  20. 20. <ul><li>It is the commonest type of G.stones </li></ul><ul><li>mainly d/t : </li></ul><ul><ul><li>Abnormality in liver synthesis of bile : </li></ul></ul><ul><li>- Reduction in bile salt or phospholipid </li></ul><ul><li>- Excessive amount of cholesterol. </li></ul><ul><ul><li>Genetic & dietary factors </li></ul></ul>Cholesterol Stones
  21. 21. Cholesterol Gallstones Formation <ul><li>formation of gall stones pass through 3 processes : </li></ul>
  22. 22. Risk factors Gallstones Formation
  23. 23. Types of Cholesterol stones <ul><li>There are two types: </li></ul>90-100% Solitary , Whitish > 2.5 cm 50 - 90% Multiple , Small ,# Variety of shape
  24. 24. PIGMENTED GALLSTONES - Calcium bilirubinate - Ca Soap - Bacteria has role in the synthesis - > in Asia - Mainly at bile duct -Periumpullary duodenal diverticula -Excess Bilirubin - > in : -Elderly Pt. - Chronic haemolysis - Alcoholic
  25. 25. <ul><li>Asymptomatic . </li></ul><ul><li>Biliary cholic . </li></ul><ul><li>Calcular cholecystitis . </li></ul><ul><li>Cholangitis . </li></ul><ul><li>Obstructive jaundice . </li></ul><ul><li>Gallstone ileus </li></ul><ul><li>Gallstone pancreatitis </li></ul>Complications
  26. 26. Conclusion <ul><li>The bile play a major role in the excretion of cholesterol & absorption of fat sol Vit. </li></ul><ul><li>Alteration of bile composition lead to the formation of GS . </li></ul><ul><li>Finally GB hypomotility & bile stasis promote GS formation . </li></ul>
  27. 27. THANK YOU
  1. A particular slide catching your eye?

    Clipping is a handy way to collect important slides you want to go back to later.

×