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PREDISPOSING FACTORS: Family History Female Middle age
PRECIPITATING FACTORS: Diet Obesity Rapid weight loss Use of oral contraceptives Gallbladder, pancreatic or ileal disease Low HDL cholesterol level Hypertriglyceridemia MRI RESULTS: 1. Dilated cystic side branches in direct communication with pancreatic duct in the region of uncinate process for which an IPMT should be excluded 2. Multiple gallstones 3. Left renal cysts with wall calcifications 4. Tiny right renal corticocysts corticocysts 5. Ascending and descending diverticula
CHOLELITHIASIS Gallstones in the Bile duct
Increased Bile Cholesterol
Precipitate out of the bile Irritation of Gallbladder Gallbladder mucosa Forms small crystals into Gallbladder’s mucosal surface
Surface Changes Enlarges to grossly visible stones Increased Mucus Secretion Several stones develop Impaired Gallbladder emptying
Obstruction
Distension
Bile Stasis
Contractile function
Intraductal Pressure
Biliary Colic
RUQ Pain
Injury
Bile accumulates in Liver
Jaundice
Biliary Cirrhosis
Increase Serum Bilirubin
Abnormal Fat Digestion
Prorates/Tea -collared Urine
Anorexia Nausea Vomiting Weight loss Flatulence Diarrhea Fat intolerance