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Questions and Answers
What is the treatment of choice for symptomatic gallstone disease?
What is the treatment of choice for symptomatic gallstone disease?
What is the pathogenesis of biliary colic?
What is the pathogenesis of biliary colic?
What is the diagnosis of gallstone disease confirmed with?
What is the diagnosis of gallstone disease confirmed with?
What is a complication of total parenteral nutrition?
What is a complication of total parenteral nutrition?
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What is the characteristic of gallstone ileus?
What is the characteristic of gallstone ileus?
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What is the effect of opioid analgesics on the sphincter of Oddi?
What is the effect of opioid analgesics on the sphincter of Oddi?
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What is the characteristic of symptoms in biliary colic?
What is the characteristic of symptoms in biliary colic?
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What is the management of gallstone ileus?
What is the management of gallstone ileus?
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Study Notes
Gallstone Disease
- Asymptomatic gallstones do not require treatment.
- Laparoscopic cholecystectomy is the preferred treatment for symptomatic gallstone disease.
Biliary Colic
- Biliary colic occurs when the gallbladder contracts against a gallstone that temporarily blocks the cystic duct.
- Classic symptoms of biliary colic include:
- Episodic postprandial right upper quadrant or epigastric pain
- Nausea
- Vomiting
- Notably, vital signs, white blood cell count, and liver function studies remain normal.
- Diagnosis is confirmed with an abdominal ultrasound demonstrating the presence of gallstones.
Sphincter of Oddi Dysfunction
- Sphincter of Oddi dysfunction is a functional biliary disorder due to dyskinesia or stenosis of the sphincter of Oddi.
- Symptoms include:
- Recurrent, episodic pain in the right upper quadrant or epigastric region
- Corresponding elevations in aminotransferases and alkaline phosphatase
- Opioid analgesics (e.g., morphine) may cause sphincter contraction and precipitate symptoms.
Gallstone Ileus
- Gallstone ileus results from small bowel obstruction due to a gallstone that has passed through a biliary-enteric fistula.
- The stone may cause "tumbling" obstruction before ultimately causing complete obstruction.
- Treatment involves surgical removal of the stone and cholecystectomy.
Total Parenteral Nutrition and Gallstone Formation
- Total parenteral nutrition causes gallbladder stasis, predisposing to:
- Gallstone formation
- Bile sludging
- These conditions may lead to cholecystitis.
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Description
Learn about the diagnosis and treatment of gallstone disease, including asymptomatic and symptomatic cases.
