Gallstone disease (Cholelithiasis) – pathogenesis, prevention and contemporary methods of imaging diagnostics

2017 
INTRODUCTION : Cholelithiasis is a metabolic disorder, leading to stone formation in the bile ducts and gall­bladder. The stones are classified by their composition as cholesterol, pigment, and mixed. The condition is more frequent in overweight individuals, with a stationary way of life, diabetics, and women on oral contracep­tives. There is a female predilection with a 3.5:1 ratio. The disease has several forms. The latent one is devoid of complaints – stones are an incidental finding. The acute form manifests with right upper quadrant pain. Bili­ary colic is typical – it comes in fits of right subcostal pain, nausea, and frequently - vomiting. Complications are frequent – gallbladder and bile duct inflammation, biliary obstruction, gallbladder perforation, and bili­ary peritonitis. AIM : To analyze the pathogenesis, the prevention and the modern medical imaging methods related to the gallstones disease. MATERIALS AND METHODS : This research applied statistical methods. The data was processed through sta­tistical and graphical analysis. RESULTS : Accurate diagnosis requires a compound approach. Anamnesis of biliary colic initiates it. Abdomi­nal ultrasonography is the fastest and most accessible imaging method for finding gallstones. It can also pres­ent the gallbladder itself – whether it is enlarged, inflamed, or folded. Additional methods include magnetic resonance imaging (MRI), computed tomography (CT), and some hybrid techniques. If the data of cholelithi­asis is ambiguous, the latter can be confirmed by endoscopic retrograde cholangiopancreatography (ERCP) – an endoscope is introduced to the level of the papilla of Vater, and contrast is injected into it. The biliary path­ways also used to be imaged by percutaneous transhepatic cholangiography, which now is a dated technique. CONCLUSIONS : Prophylaxis includes avoiding risk factors of alimentary nature and undergoing periodic con­trol ultrasonographies, especially in individuals with a family history of gallstones. This is crucial, as chronic
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