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Gallstone Disease/Cholelithiasis/Cholecystitis
Published in Charles Theisler, Adjuvant Medical Care, 2023
Dietary Factors: There is evidence that a diet low in refined sugar and high in fiber may help prevent gallstones by enhancing the flow of bile. Gallstones are extremely rare in Africa and other parts of the world where the diet is high in fiber and low in refined sugar.3
Questions 1–20
Published in Anna Kowalewski, SBAs and EMQs in Surgery for Medical Students, 2021
This patient is likely to be suffering from cholecystitis. The pain is in the right upper quadrant and it radiates to the back at around T7. There is marked tenderness in the right hypochondrium and Murphy’s sign may be present. Place two fingers over the right upper quadrant under the costal margin and ask the patient to breathe in; listen for a wince or gasp (arrest of breathing) with pain as the gallbladder moves and hits the fingers. However, this must be negative on the left- hand side and it is not a very accurate sign. Ultrasound should confirm the presence of gallstones. Remember the 5 Fs of gallstones: fair, fat, forty, fertile and female.
Abdominal surgery
Published in Roy Palmer, Diana Wetherill, Medicine for Lawyers, 2020
The principles of abdominal surgery include taking a proper history, proper examination, appropriate explanation and consent, appropriate surgical procedures, and careful follow-up. The introduction of endoscopic techniques, laparoscopic techniques, and minimally invasive procedures for the treatment of many conditions has changed the practice of abdominal surgery. The introduction of medication for the treatment of peptic ulcers is one example of how a whole section of abdominal surgery has disappeared. The introduction of drugs to treat gallstones could affect the treatment of gallbladder disease in the future, although removal of the gallbladder and the treatment of stones remains the most effective form of treatment. Medicine, like many other ‘high-tech’ subjects, changes rapidly. Educating surgeons and the public remains an important function. Patients must have realistic expectations and should fully understand the principles of the surgical procedure and the expected outcome. Complications can occur even when the most experienced surgeons are operating and they do not by themselves represent negligence. All surgeons experience complications but it is the recognition of the complication and the appropriate management of that complication which differentiates the negligent surgeon from the surgeon who is carrying out his practice in accordance with standard clinical practice.
Distinct lipid profile in haemolytic anaemia-related gallstones compared with the general gallstone
Published in Annals of Medicine, 2023
Ziqi Wan, Xiaoyin Bai, Chengqing He, Yueyi Zhang, Ying Wang, Kaini Shen, Li Meizi, Qiang Wang, Wu Dongsheng, Yunlu Feng, Aiming Yang
Electronic medical records were retrospectively reviewed to collect patients’ baseline information, data regarding laboratory tests and clinical courses. The baseline information included age, sex, height, weight, blood pressure, history of hypertension or diabetes mellitus (DM) and length of hospital stay. The laboratory tests included complete blood counts (haemoglobin, platelets, neutrophils and reticulocyte percentage), liver biochemistry tests (total bilirubin, direct bilirubin, alanine transaminase (ALT), aspartate aminotransferase (AST), lactic dehydrogenase (LDH) and γ-glutamyl transferase (GGT)), kidney function tests (creatine (SCR), uric acid (UA) and urea (BUN)), fasting blood glucose and serum lipids. We extracted values obtained from the last two tests before any treatment related to anaemia (for the case group) or gallstones (for the control group), and presented the mean value. The clinical courses generally included features of haematolytic anaemia (onset, causes, treatments and complications) and characteristics of gallstones (onset, symptoms, ultrasound results, acute diseases, treatments and complications). Symptoms related to haemolytic anaemia included fatigue, weakness, shortness of breath, jaundice, dark urine and splenomegaly. Symptoms of acute gallstone diseases included abdominal pain, fever and jaundice. Data were censored on December 2022.
Prophylactic cholecystectomy in individuals with spinal cord injury: A systematic review
Published in The Journal of Spinal Cord Medicine, 2023
Fernanda Barros Viana, Júlia Barros Viana, Paulo Sérgio Seabra Beraldo
According to retrospective studies, the prevalence of gallstone disease in individuals with SCI is approximately 30%.4,19 Time since injury may affect the incidence of calculous disease of the biliary tract. One study5 compared the ultrasound of individuals with SCI within six months from the injury onset with able-body subjects. The results showed 19,2% with gallbladder sludge in the SCI group compared with none of the control group and 7,7% with gallstone compared with 3,85% of the control population. All the patients who developed gallstones had a post-injury duration longer than four months.5 In the general population, the prevalence of gallstones is 20%, according to more recent studies,7 and it tends to increase due to the obesity epidemic.
Microstructural and heavy metal analysis of gallstones prevalent in Jharkhand and its implications in the treatment
Published in Postgraduate Medicine, 2023
Bhavna Sharma, Shubha Rani Sharma
Gallstone (GS) disease is considered one of the major gastrointestinal ailments in the Western countries resulting in a financial burden on the patients. Gallstones are considered small crystalline structures that are formed by the surplus of cholesterol and calcium salts and excess of bile pigments in bile. They are possibly the consequence of supersaturation of bile with cholesterol, calcium bilirubinate, carbonate, phosphate etc. The occurrence of one or more gallstones in the gallbladder can be defined as cholelithiasis [1] The size, number, type and chemical composition of gallstones vary from patient to patient, region to region as well as time also. Structural and compositional analysis of gallstones needs to be done periodically to explore the changes in the gallstones structurally as well as chemically at different intervals of time. The gallstones are mostly of three types – cholesterol, pigment or mixed [2] The predominance of cholesterol gallstones is elevated in Western people, while pigment gallstones are frequent in the population of Asia [3,4] The prevalence of gallstones shows variation in the different regions of India. The Indian population in the north is more prone (2–4 times) to gallstones than the south Indian population. The predominance of cholesterol gallstones is found among the North Indians whereas the South Indians have pigmented gallstones in common [5]. Gallstones are also linked to the ethnicity and geographical location of the patient such as cholesterol gallstones are more prevalent in northern, eastern and western India, while pigment gallstones are frequent in South India [6].