14 DISORDERS
14.1 ASYMPTOMATIC GALLSTONES
With
the routine use of ultrasound for
abdomnal complaints,
asymptomatic gallstones are being
discovered.
14.2 SYMPTOMATIC
Calculi may manifest in many ways. The affects
of symptomatic
stones are represented in Fig. above
14.3 GALLSTONE ILEUS
In
old patients with long
standing gallstones, sometimes
the
gallstone pass
into the intestine and as it passes
down, it
enlarges and gest impacted leading to
intestinal obstruction.
14.4 CYSTIC DUCT OBSTRUCTION
A
stone may block the cystic duct without any infection, as now
no bile can enter the gallbladder, it
is filled only with mucus (white
bile). The
patient presents with
a painless palpable
gallbladder.
14.5 CHOLECYSTITIS
In
nearly 90% of cases, inflammation of the gallbladder
is
associated with calculi. A bacterial cause of cholecystitis has
been
proposed and the common causative bacteria
are E.Coli,
Streptococci and Salmonella.
CHOLEDOCHOLITHIASIS
Although small
stones may pass via the
common duct into
the
duodenum, the
distal duct with its narrow lumen
can prevent
passage of
stone. This can lead to
obstructive jaundice with
chills and rigors due to cholangitis
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