Laparoscopic surgery

Gallstones

 

A.D.A.M. Medical Encyclopedia.

Cholelithiasis; Gallbladder attack; Biliary colic; Gallstone attack; Bile calculus; Biliary calculus
Last reviewed: July 6, 2009.

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Gallstones are hard, pebble-like deposits that form inside the gallbladder. Gallstones may be as small as a grain of sand or as large as a golf ball.

 

See also:

 

Causes, incidence, and risk factors

The cause of gallstones varies. There are two main types of gallstones:

  • Stones made out of cholesterol. Gallstones made out of cholesterol are by far the most common type. Cholesterol gallstones have nothing to do with the cholesterol levels in the blood.
  • Stones made from too much bilirubin in the bile. Bile is a liquid made in the liver that helps the body digest fats. Bile is made up of water, cholesterol, bile salts, and other chemicals, such as bilirubin. Such stones are called pigment stones.

Gallstones are more common in women, Native Americans and other ethnic groups, and people over age 40. Gallstones may also run in families.

The following also make you more likely to develop gallstones:

  • Failure of the gallbladder to empty bile properly (this is more likely to happen during pregnancy)
  • Medical conditions that cause the liver to make too much bilirubin, such as chronic hemolytic anemia, including sickle cell anemia
  • Liver cirrhosis and biliary tract infections (pigmented stones)
  • Diabetes
  • Bone marrow or solid organ transplant
  • Rapid weight loss, particularly eating a very low-calorie diet
  • Receiving nutrition through a vein for a long period of time (intravenous feedings)

Symptoms

Many people with gallstones have never had any symptoms. The gallstones are often discovered when having a routine x-ray, abdominal surgery, or other medical procedure.

However, if a large stone blocks either the cystic duct or common bile duct (called choledocholithiasis), you may have a cramping pain in the middle to right upper abdomen. This is known as biliary colic. The pain goes away if the stone passes into the first part of the small intestine (the duodenum).

Symptoms that may occur include:

  • Pain in the right upper or middle upper abdomen:
    • May go away and come back
    • May be sharp, cramping, or dull
    • May spread to the back or below the right shoulder blade
    • Occurs within minutes of a meal
  • Fever
  • Yellowing of skin and whites of the eyes (jaundice)

Additional symptoms that may occur with this disease include:

  • Abdominal fullness
  • Clay-colored stools
  • Nausea and vomiting

It is important to see a doctor if you have symptoms of gallstones. Gallstones are found in many people with gallbladder cancer.

Signs and tests

Tests used to detect gallstones or gallbladder inflammation include:

 

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