Gall bladder stone

Gall bladder stones are a common finding on Ultrasonography, predisposing factors are

  • Parentral nutrition
  • More common in middle aged female
  • Obesity
  • Pregnancy
  • Medications such as ceftriaxone, and estrogens
  • Rapid weight loss
  • Diseases of the ileum

Symptoms

  • Gall bladder stones may be asymptomatic and incidentally picked on routine Ultrasonography. Common symptoms are
  • Pain in upper abdomen
  • Vomiting
  • Fever
  • Jaundice
  • Stone can pass lower down in bile duct and can lead to fever, jaundice
  • Stones can pass down and transiently block pancreatic duct and lead to attack pancreatitis
  • Large stone (>3cm) are risk factor for gall bladder cancer

Diagnosis

  • Trans abdominal Ultrasonography is the best investigation for diagnosis of gall bladder stones,
    Endoscopic ultrasonography may be required for detection of very small stones in gal bladder

Treatment

  • Medical therapy is not very effective for gall bladder stones, surgery is the most effective treatment.
  • Symptomatic gall bladder stones should be operated,
  • Asymptomatic stone can be followed up, with close observation, however gall bladder with large stone (3 cm) should be operated Stone passed out in CBD should be taken out by ERCP

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