Gallstones and complications

Gallstones are the presence of stones in the biliary system including the bile ducts in the liver, gallbladder and bile ducts.

In Western countries, mostly cholesterol stones are established in the gallbladder, tropical and Asian countries are mostly bile pigments formed in the liver tube and bile ducts due to worms and infections. Gallstones are one of the diseases that easily cause dangerous complications, if not timely intervention will lead to a dangerous situation.

What is the composition of gallstones?

Gallstones include bile saline, bile pigments, calcium ., they thicken and become stones. This is a common, common type of gravel that can be detected when X-rays are taken. In addition to synthetic gallstones, there are many other types of stones such as:

Cholesterol stones : Mainly composed of cholesterol - is a metabolite of the liver, is a component of blood fat. This type is dark yellow, does not interfere. This type of stone forms when there is a disorder of cholesterol, bile acids and lecithin. There are a number of factors that promote the formation of cholesterol stones: age, gender (female / male = 3/1), race, family factors, obesity, women with multiple children, taking some drugs like lipid-lowering pills, birth control pills, excessive energy intake .

Honey pigments : Common in Southeast Asian countries including Vietnam, there are two types of black and brown.

Image of gallbladder gravel (Photo: TTO)

- Black pigmentation: irregularly shaped black, it is formed when the concentration of unconjugated bilirubin in bile increases, this is the case of hemolysis and in cirrhosis.

- Brown pigment stones: Brown or light yellow, this is the result of bile ductworms and biliary tract infections.

Honey salts : Usually red, it is also easy to associate with canci.

When will gallstones appear?

Gallstones: This type of gravel can have a long, quiet time. When clinical manifestations, symptoms are mainly liver pain, severe pain in the right flank, spread to the back and right shoulder, sometimes pain spread to the epigastric area, making it easy to mistakenly think thick. Hepatic cramps persist for more than 15 minutes to 3-4 hours, if more than 6 hours have to think about complications.

If there is a blockage, the gallbladder is getting bigger and bigger, and when the palpation touches, the gallbladder can be swollen, pressing on the patient is very painful. high fever 39 - 40o C.

Biliary stones: This type of gravel has a very diverse clinical manifestation, often due to the movement of gallstones and biliary stones in the liver. Usually there are 3 very typical symptoms (called Charco's trigeminal syndrome) that appear sequentially: first there is liver pain with the above symptoms, then there is a fever and chills. Finally, jaundice, yellow eyes, fecal stools, dark urine urination.

In addition to the clinical manifestations, special laboratory tests, including non-invasive baseline ultrasound, help detect 70-80% gravel, in addition to detect lesions of bile, gallbladder, and pancreas.

What complications can happen?

Inflammation and infection of biliary tract, gallbladder level; Gallbladder necrosis and peritoneal infiltrates are very dangerous complications that require surgical intervention and may have severe consequences. Leaks bile ducts into the gastrointestinal tract and engorges gallbladder water. Cirrhosis: This complication occurs due to long-term cholestasis with inflammation that damages the liver parenchyma and replaces it with fiber organization.

What to do when a gallstones are suspected?

Must go to a qualified medical facility to determine if you have gallstones, and from this result your doctor will give you reasonable treatment and advice.

Once the doctor has indicated treatment, the patient should follow the unintentional guidelines.

Treatment of gallstones involves treating the cause of removal of stones and treating symptoms and complications if any. When medical treatment can use smooth muscle antispasmodic drugs such as atropine, papaverin, nospa, visceralgin .; anti-bacterial drugs such as aminoglycosides, quinolones .; group of drugs to dissolve stones like chenodex, ursolvan ., however, when using these drugs, there must be indications from a specialist.

When medical treatment is ineffective, switching to surgical treatment with new techniques such as percutaneous lithotripsy, taking stones through retrograde endoscopy has brought many benefits to patients.

So how to prevent gallstones disease?

Limit the consumption of animal fat, animal visceral, be careful when using birth control pills . Eat well, periodically deworm once every 6 months. Exercising therapy, massaging the abdominal muscles in the gallbladder, can use laxatives such as chophytol, sorbitol.

According to BS. NGUYEN BACH DANG