Gallstones
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Gallstones
Pathology
Liver, gallbladder and pancreas disorders
Biliary atresia
Crigler-Najjar syndrome
Dubin-Johnson syndrome
Gilbert's syndrome
Rotor syndrome
Acute cholecystitis
Ascending cholangitis
Biliary colic
Cholangiocarcinoma
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Gallbladder cancer
Gallstone ileus
Gallstones
Alcohol-induced liver disease
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Wilson disease
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Zollinger-Ellison syndrome
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Pancreatic cancer
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Lower gastrointestinal tract disorders
Bowel obstruction
Gallstone ileus
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Volvulus
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Familial adenomatous polyposis
Gardner syndrome
Juvenile polyposis syndrome
Peutz-Jeghers syndrome
Gastroschisis
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Ludwig angina
Oral cancer
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Parotitis
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Temporomandibular joint dysfunction
Warthin tumor
Gastrointestinal system pathology review
Appendicitis: Pathology review
Cirrhosis: Pathology review
Colorectal polyps and cancer: Pathology review
Congenital gastrointestinal disorders: Pathology review
Diverticular disease: Pathology review
Esophageal disorders: Pathology review
Gallbladder disorders: Pathology review
Gastrointestinal bleeding: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Inflammatory bowel disease: Pathology review
Jaundice: Pathology review
Malabsorption syndromes: Pathology review
Neuroendocrine tumors of the gastrointestinal system: Pathology review
Pancreatitis: Pathology review
Viral hepatitis: Pathology review
Assessments
Gallstones
Flashcards
0 / 11 complete
USMLE® Step 1 questions
0 / 7 complete
High Yield Notes
13 pages
Flashcards
Gallstones
of complete
Questions
USMLE® Step 1 style questions USMLE
of complete
| Laboratory value | Result |
| Leukocyte count | 23,250/mm3 |
| Hemoglobin | 12 g/dL |
| Hematocrit | 46% |
| Platelets | 400,000/µL |
| Lipase | 140 U/L |
| AST, SGOT | 47 U/L |
| ALT, SGPT | 45 U/L |
| Total bilirubin | 0.8 mg/dL |
External References
First Aid
2022
2021
2020
2019
2018
2017
2016
Alcoholic cirrhosis p. 69, 400
cholelithiasis and p. 405
Bile salts p. 383
in cholelithiasis p. 405
Biliary tract disease p. 404
gallstones p. 377
Bilirubin p. 384
cholelithiasis p. 405
Cholelithiasis p. 405
acute pancreatitis p. 405
bile ducts and p. 377
biliary cirrhosis and p. 405
Crohn disease p. 391
hyperbilirubinemia and p. 402
octreotide and p. 409
somatostatinomas p. 357
Cholesterol
cholelithiasis and p. 405
Cirrhosis p. 398
cholelithiasis and p. 405
Crohn disease p. 391
cholelithiasis and p. 405
Gallstones p. 404
Ileus p. 395
gallstone p. 405
Obesity
cholelithiasis and p. 405
Weight loss
cholelithiasis and p. 405
Transcript
Content Reviewers
Contributors
When you eat some real fatty foods, like say some delicious french fries, they make their way to through the stomach and into the small intestine. At this point they aren’t really french fries anymore, but since they’re high in fat, they’re still a little more difficult to absorb, and that’s where your gallbladder comes in.
This high fat food stimulates the gallbladder to squeeze out some bile into the small intestine, that bile emulsifies the fat, or basically mixes the fat up, and makes it easier to absorb.
This is pretty much your gallbladder’s job—store and concentrate bile until the time comes to send it to the small intestine. It’s not the most glamorous of jobs, but hey, gotta start somewhere.
If we take a closer look at this magical substance, we’d get a rough breakdown that’s something like the following: ~70% bile salts and acids, ~10% cholesterol ~5% phospholipids, ~5% proteins, and 1% conjugated bilirubin, and the rest, small amounts of various other compounds like water, electrolytes, and bicarbonate.
Bile salts and acids are mostly a product of cholesterol metabolism, so an acid might look something like this and its salt is the anionic form, something like this (ROO-) group.
These acids and their salts have both hydrophobic and hydrophilic sides, making them amphiphilic, which help them make cholesterol and fat in the gut more soluble in bile.
The phospholipids are mostly lecithin, also amphiphilic, and also help make cholesterol and fats more soluble in bile.
Gall-stones are these round and solid stones you can find inside your gallbladder, and they’re made from the components of bile, and so they’re categorized depending on what they’re made of, the most common ones are cholesterol stones, but there’s also bilirubin stones, which are sometimes called pigmented stones.
The first type, as you might guess, are made mostly of cholesterol that has precipitated out of the bile as a solid and formed these solid stones. These account for around 75 to 90% of cases.
This cholesterol precipitation can happen in a couple ways, first, the bile can become supersaturated with cholesterol, meaning that the bile has so much cholesterol that the bile salts and acids or phospholipids can’t hold any more in solution, because remember that these all help make the cholesterol more soluble in bile, and so the cholesterol comes out of solution as a solid.
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
- "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
- "Recurrent gallstone ileus: time to change our surgery?" Journal of Digestive Diseases (2009)
- "Differences in diet and food habits between patients with gallstones and controls." Journal of the American College of Nutrition (1997)
- "Ursodeoxycholic Acid and Diets Higher in Fat Prevent Gallbladder Stones During Weight Loss: A Meta-analysis of Randomized Controlled Trials" Clinical Gastroenterology and Hepatology (2014)
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