Pathogenesis of Cholesterol Gallstones
Content
PATHOGENESIS OF CHOLESTEROL GALLSTONES Kim Szydney Racho
Cholelithiasis • Cholelithiasis is defined as the presence of stones within the lumen of the hepatic biliary tree (gallbladder or in the extrahepatic biliary tree). • Three fourths of gallstones in industrialized countries consist primarily of cholesterol • The remainder are composed of calcium bilirubinate and other calcium salts (pigment gallstones).
Cholelithiasis • Gallstones(choledocolithiasis) are often asymptomatic but may cause mild to severe pain (biliary colic) by impacting in the cystic or common bile ducts.
Cholesterol gallstones • holesterol gallstones are the most common gallstones. • holesterol stones are round or faceted! yello" to tan and single or multiple.
• #ary from 1 to 4 cm in greatest dimension • $ver %&' of the stone is composed of cholesterol the rest consists of calcium salts and mucin.
Epidemiology • EPIDEMIOLO!" #ppro$imately %&' o #merican men and %' of "omen older than the age of *% years have incidental gallstones at autopsy. • However, during their reproductive period, women are three times more likely to develop cholesterol gallstones than are men, and the incidence is higher in users of oral contraceptives and in women who have had several pregnancies.
RISK FACTORS (+emale! +orthy! +ertile! +at) • $besity • ,iabetes • -yperlipidemia-ypercholesterolemia • /se $ral ontraceptives • 0regnancy • +amilial predisposition • rohn1s ,isease • ystic +ibrosis • T02
P#*OE+E,I," The pathogenesis of cholesterol gallstones is a multifactorial process that involves physicochemical 3ualities of bile and local factors "ithin the gallbladder itself. The bile of persons afflicted "ith cholesterol gallstones has more cholesterol and less bile salts as it leaves the liver than does that of normal individuals! and the supersaturated cholesterol precipitates as solid crystals and forms stones (lithogenic bile).
Pathogenesis o Cholesterol Gallstones
Cholelithiasis • Cholelithiasis is defined as the presence of stones within the lumen of the hepatic biliary tree (gallbladder or in the extrahepatic biliary tree). • Three fourths of gallstones in industrialized countries consist primarily of cholesterol • The remainder are composed of calcium bilirubinate and other calcium salts (pigment gallstones).
Cholelithiasis • Gallstones(choledocolithiasis) are often asymptomatic but may cause mild to severe pain (biliary colic) by impacting in the cystic or common bile ducts.
Cholesterol gallstones • holesterol gallstones are the most common gallstones. • holesterol stones are round or faceted! yello" to tan and single or multiple.
• #ary from 1 to 4 cm in greatest dimension • $ver %&' of the stone is composed of cholesterol the rest consists of calcium salts and mucin.
Epidemiology • EPIDEMIOLO!" #ppro$imately %&' o #merican men and %' of "omen older than the age of *% years have incidental gallstones at autopsy. • However, during their reproductive period, women are three times more likely to develop cholesterol gallstones than are men, and the incidence is higher in users of oral contraceptives and in women who have had several pregnancies.
RISK FACTORS (+emale! +orthy! +ertile! +at) • $besity • ,iabetes • -yperlipidemia-ypercholesterolemia • /se $ral ontraceptives • 0regnancy • +amilial predisposition • rohn1s ,isease • ystic +ibrosis • T02
P#*OE+E,I," The pathogenesis of cholesterol gallstones is a multifactorial process that involves physicochemical 3ualities of bile and local factors "ithin the gallbladder itself. The bile of persons afflicted "ith cholesterol gallstones has more cholesterol and less bile salts as it leaves the liver than does that of normal individuals! and the supersaturated cholesterol precipitates as solid crystals and forms stones (lithogenic bile).
Pathogenesis o Cholesterol Gallstones
