Cholelithiasis

Question 1

what is cholelithiasis

Answer 1

• Most common disease of the gallbladder

* Single large gallstone or multiple smaller stones

Question 2

are small or big stones more dangerous

Answer 2

Tiny stones represent a larger risk due to the potenrial for biliary obstrction after entering the bilary ducts and prevent the outflow of bile

Question 3

Symptoms of cholelithiasis

Answer 3

• Usually asymptomatic until a stone is lodged within bile ducts, causing bilairy colic
• Acute RUQ pain
• Epigastric pain with radiation to right shoulder after a high fat meal
• Nausea
• Vomiting
• Pain lasts only until the stone dislodges or passes through the cystic duct

Question 4

causes of cholelithiasis

Answer 4

Five F’s (Fat, female, forty, fertile, fair)

•Pregnancy, diabetes, oral contraceptives, TPN

Question 5

Associated lab findings

Answer 5

“•Check bilirubin levels
•Acute increase in amylase
•Abnormal LFTs (Increased Alkaline phosphatase)
•AST/ALT may be normal “

Question 6

Sonographic appearance

Answer 6

“•Dilated gallbladder
•Hyperechoic intraluminal echoes with posterior acoustic shadowing
•WES sign
•Gravity dependant calcifications in gallbladder “

Question 7

DD

Answer 7

"•Duodenal gas
•Porcelain gallbladder
•Sludge 
•Sludge ball
•Gallbladder polyps "

Question 8

GB Polyps

Answer 8

These do not move – attached to wall

Question 9

Sludge balls

Answer 9

Usually larger and without a shadow