Gallstone Disease Diagnosis

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.

Learn about the diagnosis and treatment of gallstone disease, including asymptomatic and symptomatic cases.