GALLSTONES
The etiology of gallstones has not
been agreed upon. In all the
theories, there
is the need to explain the
precipitation of
cholesterol.
*
Infection and stasis are considered major factors.
*
In the infection theory, damage to the
gallbladder mucosa
initiates stone formation.
*
This damage to the wall results
in a change of permeability,
bile salts diffuse
from the bile into
the blood stream
decreasing their concentration
in bile and
reducing the
cholesterol holding capacity in the bile.
*
Constitutional and metabolic factors have been
implicated.
The incidence of formation of stones is definitely related to
the sex and age. In all age
groups, stones are more frequent
in females than in male, there is
also an increase with age
more frequent in
females than in male, there is
also an
increase with age in both sexes.
*
Major elements involved in the formation of gallstones
are
cholesterol, bile pigment and calcium. Other
constituents
include iron, phosphorus, carbonates and proteins.
*
Pure cholesterol stones are uncommon, usually large,
round
with a smooth surface.
*
Pure bilirubin pigment stones are
also uncommon and are met
with in hemolytic jaundice.
*
Calcium bilirubinate stones
are prevalent in
Asia and
constitute 30 to 40% of all gallstones.
*
A nucleating factor that starts the process of stone formation
is important foreign bodies, ova,
bacteria, cellular debris
are some factors that play a role.
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