The gallstones, commonly known as gallstones or cholelithiasis are accretions of solids that form in the gallbladder. Can be as small as grains of sand or, in exceptional cases, so great that occupy the entire bladder. Most, however, are usually of intermediate size, i.e. less than 20 mm, about an inch.

There are two main types of gallstones:

1. Those cholesterol composed mostly by the drug, representing about 80% of all cases diagnosed in the United States.
2. The pigment, consisting mostly of calcium salts of bile pigments and other compounds, which account for 20% of diagnosed cases.

Since most patients have cholesterol gallstones, can be treated without resorting to surgery. The kind of calculation is important because only cholesterol stones can be treated by non- surgical.

Complications

In many patients, the stones remain “silent,” that is asymptomatic and pose few problems of importance. However, the longer you have been present, the greater the likelihood of causing complications. In a given patient, the likelihood of an upset dumb calculation is about 3% per year. So, after 20 years most people who have asymptomatic gallstones will ultimately experience symptoms. Once appeared, the symptoms persist. And if the problem affects older people, treatment may be much more difficult, especially if you have other medical problems.

As they increase in size, gallstones can block the outlet of the gallbladder and thus lead to serious character disorders. The obstruction may begin gradually or occasionally accompanied by inflammation of the gallbladder (chronic cholecystitis), and end in total obstruction, with acute inflammation of the gallbladder (cholecystitis) Box that requires surgery.

Other complications may occur when gallstones block the common bile duct (choledochal) that leads to the intestine. It is also possible infection of the bile ducts (cholangitis acute), accompanied by chills and fever. Bile pigments sometimes accumulate in the blood, producing jaundice, which is manifested by a yellowing of the skin. You can also place an acute inflammation of pancreas (pancreatitis.) If the bile duct remains blocked for a long time, the liver damaged, liver failure can occur and even death. On rare occasions, pass the small intestine large stones, which are obstructions near the junction between the small intestine and thickness.

Symptoms

There are many persons who have gallstones have no symptoms. When symptoms are evident, the bearer of gallstones may experience:

* Followed by severe pain in the upper abdomen, this pain may spread to chest, Shoulders and back and is sometimes confused with symptoms of a heart attack.

* Indigestion, nausea or vomiting.
* cholangitis
* pancreatitis
* fistulas
* drilling

* Abdominal pain and tenderness in the right side of the abdomen where the gallbladder is inflamed.

* Jaundice, chills and fever when gallstones block the passage of the bile.

It is noted that when the liquid is blocked attack can be a pain. This pain in the abdomen is on the rise, lasting half an hour to several hours.

Diagnosis

Most gallstones can be described by simple and painless techniques. Patients who complain of abdominal pain or gastrointestinal upset often receive specific tests for diagnosing the presence of gallstones.

Often just an ordinary X-ray of the abdomen to find the calculations, especially if they are rich in calcium.

There is another more sensitive technique, called, ultrasonography, with which it produces an image or photograph of the gallbladder and bile ducts, allowing the physician to determine if there is some calculation in mind, whatever their class. This method is the most widely used, not to emit.

A third technique is called cholecystography and requires prior swallowing pills that contain dyes. The dye travels in the bloodstream to the gallbladder and highlights the outline of it so that calculations can be detected by radiography.

When you suspect the presence of stones in the bile ducts are required more complicated procedures.

In the ERCP (endoscopic retrograde cholangiopancreatography) is introduced into the small intestine a flexible tube passed into the bile duct, then inject a dye into the ducts and an x-ray is taken.

When using a technique called PTC (percutaneous transhepatic cholangiography) is through the abdomen with a very thin needle that is passed to the network of ducts in the liver. Then inject dye and take x-rays.

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