Definition and causes
Gallstones are small or large rocks that can be formed in the gallbladder, when the balance of bile composition differs from the norm. Gallstones are frequent, but the state gives first symptoms when the stone blocks drained from the gallbladder or is stuck in the deep bile times on the way to the gut.
Bile is fluid and formation in the liver of, among other things, cholesterol and wastes, including billirubin (colored product from dead red blood cells) and assembled in the gallbladder, which sits in close relation to the liver. When you eat, headed bile through the deep bile times to gut, where bile is necessary for digestion of essential fats and neutralizing stomach acid. While waste is then excreted in faeces, which is why its dark color. See also liver, ga
When the balance between the substances in the bile pushed too much towards high cholesterol can be deposited in cholesterol crystals, which are the most common basis for gallstones. Blocks grows when bile ingredients bind to the solid crystals and is composed of cholesterol, bile pigment and lime (calcium). There may be many small stones or some large, which may be larger than a hen. Large stones do not need to give serious symptoms.
Gallstones are frequent and can be found in 5-10% of the Danish population. In older seen it in up against 1/3-del. Due to hormonal causes are gallstones 2-3 times more often in (particularly) women than in men. Blocks (both large and small) are, however, often randomly by other studies, with very few is stuck and symptoms.
Symptoms of gallstones
As mentioned above, the gallstone only symptoms, if it is stuck and blocking the gall bladder bile drainage to the aisle. Alternatively, the stone become lodged further down into the deep bile times (choledocholithiasis), typically at the mouth of the intestine. This is seen in 5-10% of persons with gallstone disease and may offer some other complications and diseases than gall bladder stones (cholecystolithiasis).
The symptoms of gallstones typically come in fits and often right after you have eaten. They include:
- Heavy, right sudden pain in the right edge rib, perhaps. with radiation to the back or shoulder (pain may sit elsewhere). Blades of the attack over several hours.
- Often while nausea and vomiting.
- Restlessness (due to pain).
In addition, there are:
- Yellowing of the skin and eyes called jaundice.
- Discoloration of the faeces, which become kitfarvet (reason: See jaundice).
- Dark staining of urine, there are reports or cola-colored (reason: See jaundice).
There may be complications as infection (see below) and in these cases will develop a fever may. with chills and more constant pain. By stones in the gallbladder that could symptoms fluctuate in intensity, because a stone here, alternating can block and allow passage of bile.
Complications of gallstones
Stones in the gallbladdercan provide various complications:
- The infection of the gallbladder (cholecystitis).
- Gall stones in the road (choledocholithiasis).
- Formation of a channel from the gallbladder, for example. small intestine, through which even large stones can pass and block the intestine and give symptoms of tarmslyng (mechanical ileus). This happens rarely.
Gall stones in the aislecan also provide:
- Infection in bile aisle (cholangitis), which provides high fever (above 39 degrees), and jaundice are relatively frequent.
- Acute pancreatitis (acute pancreatitis) may occur. This is because the pancreas exports started to run along with bile ducts, and a stone can block both drains to the intestine (see liver, gallbladder and pancreas).
Precautions and diagnosis
The sharp pain of gallstone attacks are usually quickly people to seek medical advice. The symptoms gives suspicion, and the diagnosis is made by an ultrasound examination, which usually also can detect these complications.
However, it is not always possible to find any stones on ultrasound, but blood tests, liver can give you an idea of whether there is a blocked bile roads. In addition, you can make an ultrasound examination using a telescope instrument that by feeding through esophagus, stomach and intestine can come close to the area and provide clearer ultrasound images (endoscopic ultrasound).
Finally, you can make an MRI of bile aisle, called MRCP.
Treatment of gallstone
The treatment of stones in the gallbladder and bile stones in the corridors are a little different.
Stones in the gallbladder
Treated with surgical removal of the gallbladder. The operation takes place today as a telescope operation through small holes in the abdomen and called laparaskopisk cholecystektomi. It occurs very rarely complications of this operation, but should they arise along the way, it may be necessary to open up and operate in the traditional way. The advantage of the telescope method is faster hospital (after 1-2 days) and to come more quickly (within 1-2 weeks).
You can easily do without the gallbladder, bile as ever produced in the liver. The float just more constant rather than delivered to the intestine when the gallbladder pulling together after meals. Almost all are healed and asymptomatic after surgery, but a few are experiencing inexplicably symptoms as those they had before the operation. This will not always find the reason for this.
Gall stones in the aisle
These can sometimes be removed with a telescopic instrument (endoscope), which led down into the intestine through the mouth and esophagus. Here are galdegangens udmundingshul to the intestine, and expanded by opening a small cut. Then remove stones in the bile ducts with a small gribeklo on the instrument (a rock prisoners). The procedure called ERCP and can be used on almost all biliary stones. The remaining stones may be. attempted crushed by high-frequency sound waves.