Gallstones form when certain substances harden in the gallbladder or bile ducts. Risk factors include family history, being a woman over 40, obesity, high-fat diet, and certain medical conditions. Gallstones can cause inflammation of the gallbladder, blockage of ducts, pancreatitis, and rarely cancer. Diagnosis involves ultrasound, blood tests, and endoscopy. Treatment is usually surgical removal of the gallbladder to prevent complications from gallstones.

1. cholelithiasis
Prepared by
Mr.Abhay Rajpoot
HOD (Dep. of Medical Surgical)
abhayrajpoot5591@gmail.com

2. INTRODUCTION
 Gallstones are hardened deposits of digestive fluid that can form in the
gallbladder. The gallbladder is a small, pear-shaped organ on the right
side of your abdomen, just beneath the liver. The gallbladder holds a
digestive fluid called bile that's released into the small intestine.
 Gallstones range in size from as small as a grain of sand to as large as
a golf ball. Some people develop just one gallstone, while others
develop many gallstones at the same time

4. DEFINITION
Gallstones are stones or lumps that develop in the gallbladder or bile duct
when certain substances harden. The gallbladder is a small sac located on
the right-hand side of the body, on the underside of the liver.

6. RISK FACTOR
• Have a family history of them
• Are a woman
• Are over age 40
• Are obese
• Have a diet high in fat and cholesterol but low in fiber
• Don’t get much exercise
• Use birth control pills or hormone replacement therapy
• Are pregnant
• Have diabetes
• Have an intestinal disease like Crohn’s
• Have hemolytic anemia or cirrhosis of the liver
• Take medicine to lower your cholesterol
• Lose a lot of weight in a short time

7. CAUSES
 Too much cholesterol. Normally, bile contains enough chemicals to dissolve the
cholesterol excreted by the liver. But if liver excretes more cholesterol than your bile
can dissolve, the excess cholesterol may form into crystals and eventually into stones.
 Bile contains too much bilirubin. Bilirubin is a chemical that's produced when the
body breaks down red blood cells. Certain conditions cause your liver to make too
much bilirubin, including liver cirrhosis, biliary tract infections and certain blood
disorders. The excess bilirubin contributes to gallstone formation.
 Gallbladder doesn't empty correctly. If gallbladder doesn't empty completely or
often enough, bile may become very concentrated, contributing to the formation of
gallstones

8. TYPES OF GALLSTONES
Types of gallstones that can form in the gallbladder include:
 Cholesterol gallstones. The most common type of gallstone, called a
cholesterol gallstone, often appears yellow in color. These gallstones are
composed mainly of undissolved cholesterol, but may contain other
components.
 Pigment gallstones. These dark brown or black stones form when your
bile contains too much bilirubin

9. SIGN AND SYMPTOMS
 Sudden and rapidly intensifying pain in the upper right portion of your
abdomen
 Sudden and rapidly intensifying pain in the center of your abdomen, just
below your breastbone
 Back pain between your shoulder blades
 Pain in your right shoulder
 Nausea or vomiting

11. DIAGNOSTIC EVALUATION
 Physical examination
 History collection
 Abdominal ultrasound. This test is the one most commonly used to look for
signs of gallstones. Abdominal ultrasound involves moving a device
(transducer) back and forth across your stomach area.
 Endoscopic ultrasound (EUS). This procedure can help identify smaller
stones that may be missed on an abdominal ultrasound. During EUS your
doctor passes a thin, flexible tube (endoscope) through your mouth and
through your digestive tract.
 Blood tests. Blood tests may reveal infection, jaundice, pancreatitis or other
complications caused by gallstones.

12. Endoscopy

13. COMPLICATION
 Inflammation of the gallbladder. A gallstone that becomes lodged in the
neck of the gallbladder can cause inflammation of the gallbladder
(cholecystitis). Cholecystitis can cause severe pain and fever.
 Blockage of the common bile duct. Gallstones can block the tubes (ducts)
through which bile flows from your gallbladder or liver to your small
intestine. Severe pain, jaundice and bile duct infection can result.
 Blockage of the pancreatic duct. The pancreatic duct is a tube that runs from
the pancreas and connects to the common bile duct just before entering the
duodenum. Pancreatic juices, which aid in digestion, flow through the
pancreatic duct.

14.  A gallstone can cause a blockage in the pancreatic duct, which can lead
to inflammation of the pancreas (pancreatitis). Pancreatitis causes
intense, constant abdominal pain and usually requires hospitalization.
 Gallbladder cancer. People with a history of gallstones have an
increased risk of gallbladder cancer. But gallbladder cancer is very rare,
so even though the risk of cancer is elevated, the likelihood of
gallbladder cancer is still very small.

15. PREVENTION
 Don't skip meals.
 Lose weight slowly.
 Eat more high-fiber foods.
 Maintain a healthy weight.

17. SURGICAL MANAGEMENT