Group 1 Cholelithiasis 2018A

MEDICAL ENGLISH
GROUP 1
2018-A
1 2 3 4 5 6 7
NAME OF GRUP 1
 OPHIELYA THISNA
 RA Intan Dwi S.
 DILLA DAYANA PUTRI
 DEWI RAMBU HANA PANDJUKANG
 AGUS WINANGUN
 ANGGA PUTRA . S . R .
 I PUTU WAHYU WIDNYANA YASA
CHOLELITHIASIS
What is Cholelithiasis?
Cholelithiasis develop inside the gallbladder and are hard,

pebble-like deposits that develop inside the gallbladder. They
can be as small as a sand grain or as big as a golf ball.
Complications include: Acute and chronic cholecystitis,
cholangitis, choledocholithiasis, and pancreatitis. Surgery is
required if the patient is symptomatic.
Classification and Types of Cholelithiasis
 There are 2 Main Types of Cholelithiasis

 Stones Which are Made of Cholesterol: These are the
most common type of Cholelithiasis. Incidentally, these
cholesterol gallstones are not related to the levels of
cholesterol in the blood.
 Stones Which are Made of Bilirubin: These are formed
during hemolysis, i.e. when the red blood cells are
destroyed and this leads to excessive bilirubin production
in the bile resulting in formation of this type of gallstones.
These stones are also known as pigment stones.
Causes and Risk Factors of Cholelithiasis
 Women are more prone to developing
Cholelithiasis.
 Certain races such as Native Americans,
Hispanics are at a higher risk for developing
Cholelithiasis.
 Individuals over the age of 40 are more prone to
developing Cholelithiasis.
 Gallstones may also be hereditary.
Other Risk Factors Include
 Solid organ transplant.
 Bone marrow transplant.
 Diabetes.
 Inability of the gallbladder to properly empty the bile, especially
during pregnancy.
 Cirrhosis of the liver.
 Biliary tract infections cause formation of pigmented stones.
 Medical conditions such as chronic hemolytic anemia and sickle cell
anemia which cause excessive production of bilirubin.
 Rapid weight loss after crash dieting or after bariatric surgery.
 Prolonged intravenous feedings
Signs and Symptoms of Cholelithiasis
 Some patients with gallstones may not have any
symptoms at all. The gallstones are discovered during
routine medical procedures such as x-ray, abdominal
surgery etc.
 In case of choledocholithiasis, cramping pain is present in
the center to the right upper abdomen where a large
stone blocks either the cystic duct or common bile duct
producing a condition known as biliary colic.
 The pain subsides when the stone passes into the
duodenum, which is the first part of the small
intestine.
 Pain in the right upper or middle upper abdomen
which may be dull, constant, sharp or cramping in
nature.
 The pain may radiate to the back or below the right
shoulder blade.
 Fever.
 Jaundice.
 Clay-colored stools.
 Nausea and vomiting.
Tests to Diagnose Cholelithiasis
 Ultrasound of the abdomen.
 CT scan of the abdomen.
 Endoscopic retrograde cholangiopancreatography (ERCP).
 Endoscopic ultrasound.
 Gallbladder radionuclide scan.
 Percutaneous transhepatic cholangiogram (PTCA).
 Magnetic resonance cholangiopancreatography (MRCP).
 Blood tests to check for bilirubin level.
 Liver function tests.
 Pancreatic enzymes.
Treatment for Cholelithiasis
 Some patients with Cholelithiasis may not have any
symptoms at all. The gallstones are discovered during
routine medical procedures such as x-ray, abdominal
surgery etc.
 Surgery is not required unless the patient is
symptomatic.
 Patients who have had weight-loss surgery may also need
surgery.
 The most common surgical procedure is laparoscopic
cholecystectomy. Previously, open cholecystectomy
(removal of gallbladder) was done for uncomplicated
cases. However, this is rarely done now.
 For Cholelithiasis in the common bile duct, endoscopic
retrograde cholangiopancreatography (ERCP) and
sphincterotomy may be done.
 To dissolve cholesterol gallstones, medications such as
chenodeoxycholic acids (CDCA) or ursodeoxycholic acid
(UDCA, ursodiol) may be given in pill form. However, they
take a long time to work, around two years or more and there
is a chance of recurrence of the stones after the treatment.
 Sometimes, chemicals are passed into the gallbladder via
catheter. These chemicals help in rapid dissolving of the
cholesterol stones. This treatment is rarely done now because
of its complex nature along with the chance of the chemicals
being toxic and the chance of recurrence of gallstones.
 For patients who cannot have surgery,
electrohydraulic shock wave lithotripsy
(ESWL) of the gallbladder can be done.
Although, this treatment is not used that much,
as the gallstones often come back in many
patients.
 Cholelithiasis cannot exactly be prevented;
however, individuals who are overweight should
avoid rapid weight loss to prevent gallstones.
THANK YOU FOR YOUR ATTENTION

Group 1 Cholelithiasis 2018A

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MEDICAL ENGLISH

Cholelithiasis develop inside the gallbladder and are hard,

 There are 2 Main Types of Cholelithiasis

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