Pathophysiology of CHOLELITHIASIS

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

Inflammation of Gallbladder Cholecystitis

Inflammat  Gallblad