Gallstone disease (Cholelithiasis) – pathogenesis, prevention and contemporary methods of imaging diagnostics
2017
INTRODUCTION : Cholelithiasis is a metabolic disorder, leading to stone formation in the bile ducts and gallbladder. The stones are classified by their composition as cholesterol, pigment, and mixed. The condition is more frequent in overweight individuals, with a stationary way of life, diabetics, and women on oral contraceptives. There is a female predilection with a 3.5:1 ratio. The disease has several forms. The latent one is devoid of complaints – stones are an incidental finding. The acute form manifests with right upper quadrant pain. Biliary colic is typical – it comes in fits of right subcostal pain, nausea, and frequently - vomiting. Complications are frequent – gallbladder and bile duct inflammation, biliary obstruction, gallbladder perforation, and biliary peritonitis. AIM : To analyze the pathogenesis, the prevention and the modern medical imaging methods related to the gallstones disease. MATERIALS AND METHODS : This research applied statistical methods. The data was processed through statistical and graphical analysis. RESULTS : Accurate diagnosis requires a compound approach. Anamnesis of biliary colic initiates it. Abdominal ultrasonography is the fastest and most accessible imaging method for finding gallstones. It can also present the gallbladder itself – whether it is enlarged, inflamed, or folded. Additional methods include magnetic resonance imaging (MRI), computed tomography (CT), and some hybrid techniques. If the data of cholelithiasis is ambiguous, the latter can be confirmed by endoscopic retrograde cholangiopancreatography (ERCP) – an endoscope is introduced to the level of the papilla of Vater, and contrast is injected into it. The biliary pathways also used to be imaged by percutaneous transhepatic cholangiography, which now is a dated technique. CONCLUSIONS : Prophylaxis includes avoiding risk factors of alimentary nature and undergoing periodic control ultrasonographies, especially in individuals with a family history of gallstones. This is crucial, as chronic
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