Cholilithiasis refers to the presence of gallstones in the gallbladder. Gallstones are crystalline formations that develop from the accumulation of bile components. There are three main types of gallstones: cholesterol stones, pigment stones, and mixed stones. Risk factors for developing gallstones include female gender, family history, obesity, diet high in fat and cholesterol, older age, and certain medical conditions or drugs. Symptoms include pain in the right upper abdomen or under the right shoulder, nausea and vomiting, and clay-colored stools. Gallstones are diagnosed through imaging tests, blood tests, or endoscopic procedures and can be managed through medications, surgery, shockwave lithotripsy, or diet and lifestyle changes

1. CHOLILITHIASIS
SLIDESHARE BY-
ABHISHEK BISHT

2. INTRODUCTION
• Chlolilithiasis is made up from two words – Choli + Lithiasis
• Chole- Gall bladder ,, Lithiasis – Stone
• So Chlolilithiasis means ( Presence of Stones in gall bladder)
• A gallstone is a Crystalline concretion formed within the gallbladder by
accumulation of the bile components

3. TYPES OF GALLSTONES
(a) Cholesterol stones : Yellow to dark green
(b) Pigment stones: Pigment Stones are small and dark
(c) Mixed stones: Contain 20-80% cholesterol

4. ETIOLOGY
• Gender: Women are twice as likely as men
• Family history
• Obesity
• Diet : Diet high in fat and cholesterol
• Age : People older than age 60 are more likely to develop gall stones than younger
people
• Hypolipidemic drugs
• Hyperglycemia

5. PATHOPHYSIOLOGY
Chlolesterol mixed with bile and
lecithin
Saturation of Cholesterol with bile
Cholesterol hypersecretion
Supersaturation of cholesterol
Secretion of mucin gel
Reduced glycoprotein
Cholesterol bile mixture
Formation of cholesterol Mixed
stones

6. PICTURE – SHOWING GALL STONES

7. SIGN AND SYMPTOMS
• Steady pain in right upper abdomen
• Pain under right shoulder
• Murphy’s sign(guarding type of respiratory pain radiates towards the back and
scapula)
• Nausea and vomiting
• Hyperthermia
• Clay colored stool
• Jaundice

8. DIAGNOSTIC EVALUATION
• History collection
• Physical examination (sign and pain )
• CT scan
• Cholescintigraphy scan
• Blood test
• ERCP – Endoscopic retrograde choleangiopancreatography

9. MANAGEMENT
• Pharmacological management
• Opioid analgesic
• Antispasmodic
• Antiemetic
• Bile acid therapy
• Chenodeoxycholic acid to reduce the cholesterol stone

10. • Surgical management
• Extracorporeal shock wave lithotripsy
• Percutaneous transhepatic biliary catheter insertion

11. • Nursing management
• Monitor weight daily
• Assess the pain of the patient and provide medication
• Provide low cholesterol diet to the patient
• Provide frequent and small amount of meal