Risk Factors Fair Female Fat Forties Fertile also DM, family Hx
Epidemiology Why do you need to know about it? 2 nd most common abdo organ requiring surgery Population prevalence 5-20% of which majority (70-80%) remain asymptomatic 1-4% develop symptoms each year
Biliary Colic - Symptoms Site Onset Timing Character Radiation Severity Assoc sympt Aggrav/reliev
Biliary Colic - Symptoms SiteRUQ Onsetsudden Timing30 min – 6 hrs Characterdull Radiation +/- to epigastrium, back Severityvery Assoc symptnausea & vomiting Aggrav/reliev fatty foods, analgesics
Cholecystectomy: Indications & Timing Not indicated for incidental findings of cholelithiasis that are asymptomatic Elective for biliary colic During admission elective or urgent for acute cholecystitis Alternatives if unfit for surgery – Abx and percutaneous drainage
Cholangitis When obstructed CBD becomes infected Charcot’s triad of signs – RUQ pain – jaundice – High fever/rigors Can be life threatening, early treament essential
Gallstone Ileus When stone perforates GB wall and erodes into duodenum, obstructing small bowel Treatment - laparotomy
Pancreatitis When gallstone irritates pancreas causing inflammation, or distal CBD blockage causing intrapancreatic release of enzymes 30-50% pancreatitis caused by gallstones Can be life threatening
Take home messages Gall stone disease very common, worth knowing about, understanding anatomy helps Feel lots of bellies Complications can be life threatening Get scrubbed for a cholecystectomy!
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