Gallbladder Stone symptoms in Hindi I Cholelithiasis in Hindi I Dr. Shipra Mishra

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Stone in gall bladder- Cholelithiasis
If Stone migrate into duct of biliary tract- Choledocholithiasis
Common in 5th & 6th decade & very rare in 2nd decade
F:M= 4:1
4F- Fat, Fertile, Female, Above Forty

Component of gallstone- Cholesterol, Bile, Calcium, Bilirubin, Carbohydrate & Phosphorus

1- Cholesterol stone- 6% common
  Pure Cholesterol stone      
                      Oval/ Round Shape
  Pale yellow in color
2- Pigment stones- 4-5%
 Very rare & small in size, Multi numbers
 Dark green / black color

3- Mixed stone- 90% common
 Cholesterol, Calcium salt of phosphate carbonate, Palmitate, Proteins

Etiology-

Metabolic factor- Cholesterol precipitate
Reflex factor- disturbance of bile salt & lecithin ratio(25:1)    below 13:1 leads to cholesterol precipitation
Stasis factor- due to Estrogen therapy, Pregnancy, Vagotomy
Infective- E. Coli, Salmonella
Increased Bilirubin Production- sickle cell anemia, malaria etc.

Risk Factor-
Women, Obesity, Sedentary life style
Liver disease, Altered enterohepatic circulation
Ileal disease, ileal resection
Rapid weight loss
Birth control pills

Clinical feature-

Biliary colic with periodicity
Nausea
Vomiting
Fever
Anorexia
Flatulent
Dysphagia

Signs-

1- Murphy’s Sign- Pressure on Rt. Hypochondrium- Winching on pt. face

2- Boas Sign- Pt. in prone position
 Pressure on 9th & 11th intercostal space
 Pt. feels severe pain  

Investigation-

CBC
LFT
Serum bilirubin increases
Plain abdomen X-ray
Lateral X-ray (Spine)
USG

Conservative T/t-

Silent condition doesn’t require any management
Analgesic
Antispasmodic
Anti-inflammatory
Oral drug therapy

Surgery-
Laparoscopic Cholecystectomy
Open Cholecystectomy

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