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Gall stones
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- 4. VAST MAJORITYVAST MAJORITY REMAINREMAIN ASYMPTOMATICASYMPTOMATIC FORDECADESFOR DECADES TOGETHERTOGETHER
- 9. TYPES CHOLESTEROL STONES –80%CHOLESTEROL STONES – 80% CRYSTYALLINECRYSTYALLINE CHOLESTEROLCHOLESTEROL MONOHYDRATEMONOHYDRATE PIGMENT STONESPIGMENT STONES
- 11. WHO ARE ATRISK ?
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- 15. BILE SUPERSATURATED WITHBILESUPERSATURATED WITH CHOLESTEROLCHOLESTEROL GB HYPOMOTILITY PROMOTESGB HYPOMOTILITY PROMOTES NUCLEATIONNUCLEATION ACCELERATED NUCLEATIONACCELERATED NUCLEATION MUCUS HYPERSECRETION TRAPSMUCUS HYPERSECRETION TRAPS CRYSTALS AND PERMITSCRYSTALS AND PERMITS AGGREATION.AGGREATION.
- 17. PREGNANCYPREGNANCY RAPID WEIGHT LOSSRAPIDWEIGHT LOSS TPNTPN PROLONGED FASTINGPROLONGED FASTING SPINAL CORD INJURYSPINAL CORD INJURY CONDITIONS PROMOTING DEFFECTIVE GB EMPTYING
- 18. CHOLESTEROL STONES PURITY OFSTONES VARIESPURITY OF STONES VARIES FROM 100% DOWN TOFROM 100% DOWN TO AROUND 50%AROUND 50% CA CARBONATE, PHOSPHATECA CARBONATE, PHOSPHATE AND BILIRUBINAND BILIRUBIN MULTIPLE STONESMULTIPLE STONES SURFACES ROUNDED ORSURFACES ROUNDED OR FACETEDFACETED RADIOLUCENT 80%RADIOLUCENT 80%
- 22. PIGMENT STONES INFECTIONINFECTION ––E.COLI ,E.COLI , ASCARIS LUMBRICOIDES, LIVERASCARIS LUMBRICOIDES, LIVER FLUKEFLUKE INTRAVASCULARINTRAVASCULAR HEMOLYSISHEMOLYSIS
- 24. BLACK - STERILEROOM ,BLACK - STERILE ROOM , BROWN - INFECTED GBBROWN - INFECTED GB 50-75% OF BLACK STONES ARE50-75% OF BLACK STONES ARE RADIO-OPAQUERADIO-OPAQUE
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- 29. ASYMPTOMATIC 70 TO80%ASYMPTOMATIC 70 TO 80% BILIARY PAINBILIARY PAIN CLINICAL FEATURES
- 32. SIZE DOES MATTERHERE VERY SMALL STONES ORVERY SMALL STONES OR GRAVEL ARE THEGRAVEL ARE THE DANGEROUS STONESDANGEROUS STONES
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- 40. ACUTE CHOLECYSTITIS MC REASON FORMCREASON FOR EMERGENCYEMERGENCY CHOLECYSTECTOMYCHOLECYSTECTOMY
- 43. STONES REMAIN THE PRIMARYCAUSE OF ACUTE EPISODE
- 48. ACUTE ACALCULOUS CHOLECYSTITIS POSTOP STATE AFTER MAJOR SxPOST OP STATE AFTER MAJOR Sx SEVERE TRAUMASEVERE TRAUMA SEVERE BURNSSEVERE BURNS MULTISYSTEM ORGAN FAILUREMULTISYSTEM ORGAN FAILURE SEPSISSEPSIS PROLONGED IV HYPERALIMENTATIONPROLONGED IV HYPERALIMENTATION POSTPARTUM STATEPOSTPARTUM STATE
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- 51. CHRONIC CHOLECYSTITIS SEQUEL TOREPEATED BOUTS OFSEQUEL TO REPEATED BOUTS OF ACUTE EPISODESACUTE EPISODES ROKITANSKY- ASCHOFF SINUSESROKITANSKY- ASCHOFF SINUSES PORCELAIN GBPORCELAIN GB XANTHOGRANULOMATOUSXANTHOGRANULOMATOUS CHOLECYSTITISCHOLECYSTITIS HYDROPS OF THE GALL BLADDERHYDROPS OF THE GALL BLADDER
- 63. WATCH OUT FORTHESE COMPLICATIONS CHOLANGITIS OR SEPSISCHOLANGITIS OR SEPSIS PERFORATION AND LOCAL ABSCESSPERFORATION AND LOCAL ABSCESS FORMATIONFORMATION RUPTURE WITH DIFFUSERUPTURE WITH DIFFUSE PERITONITISPERITONITIS FISTULA AND ILEUSFISTULA AND ILEUS AGGRAVATES PRE EXISTINGAGGRAVATES PRE EXISTING MEDICAL ILLNESSMEDICAL ILLNESS
- 64. CLINICAL FEATURES RUQ PAINRUQPAIN MOST PATIENTS ARE FREE OF JAUNDICEMOST PATIENTS ARE FREE OF JAUNDICE ATTACK SUBSIDES IN 7 TO 10 DAYSATTACK SUBSIDES IN 7 TO 10 DAYS ACUTE ACALCULOUS ONE PREDISPOSEDACUTE ACALCULOUS ONE PREDISPOSED TO GANGRENE AND PERFORATIONTO GANGRENE AND PERFORATION ACUTE EMPHYSEMATOUS CHOLECYSTITISACUTE EMPHYSEMATOUS CHOLECYSTITIS
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