Diagonisis and Complications of Gallstone

As most gallstones doesnot show any symptoms, in many cases, gallstones are discovered by accident when the patient is being treated for something else.

Updated: November 30, 2017

When the chemical substances present in the gallbladder such as, cholesterol, calcium bilirubinate, and calcium carbonate are out of balance and are  harden, gallstones may form.

Diagnosis of Gallstone:

As most gallstones does not show any symptoms, in many cases, gallstones are discovered by accident when the patient is being treated for something else.
A physical examination that includes checking your eyes and skin for visible changes in color can be done first. Yellowish color could be a sign of jaundice, the result of too much bilirubin in your body.
Gallstones can be diagnosed after a cholesterol test, an ultrasound scan, a blood test, or even an X-ray. There is no blood test that can identify gallstones. But it  may be used to look for signs of infection, obstruction, pancreatitis, or jaundice. If you are a woman, the blood may also be tested to check for a possible pregnancy. Kidney infections can cause abdominal pain similar to that caused by gallstones. So to rule out this a urine test can be done. The best way to examine the gallbladder for stones is ultrasound. Ultrasound uses painless sound waves to create images of organs. It can find out the abnormalities in the biliary system, including stones or signs of inflammation or infection.
An alternative to ultrasound is an oral cholecystogram (OCG). The patient swallow pills containing a safe, temporary dye which helps to show up the gallbladder and gallstones better on the X-ray.
Some alternatives to ultrasound and OCG are better choices if gallstones have left the gallbladder and moved into the ducts. These test include:

Cholescintigraphy (HIDA scan):

A small amount of harmless radioactive material is injected into an IV line in the arm of the patient. This is absorbed by the the liver and passed on to be stored in the gallbladder, which is then stimulated to contract.
If the gallbladder is inflamed, none of the marker is seen in the gallbladder, and if the gallbladder is blocked by gallstones, none of the marker is seen to leave the gallbladder. Therefore on scan it may diagnose abnormal contractions of the gallbladder or an obstruction of the bile duct.

CT scan:

This test is similar to an X-ray that produces cross-section pictures of the inside of the human body. It shows the gallbladder and the biliary ducts and can detect gallstones, blockages, and other complications.

Endoscopic retrograde cholangiopancreatography (ERCP):

A thin, flexible endoscope is used to view parts of biliary system. The patient is sedated, and the tube is passed through the mouth and stomach and into the small intestine. The device then injects a temporary dye into the biliary ducts, which makes it easy to see any stones in the ducts when X-rays are taken.
Looking at the X-rays the doctor can identify possible gallbladder or bile duct disorders, such as pancreatitis, cancer of the pancreas, or gallstones.  If the dye does not move into either the liver, bile ducts, intestines, and gallbladder, it generally means that the gallstone is causing a blockage. ERCP is also used to locate and remove stones in the bile duct.

Chest X-ray:

Sometimes problems in the chest such as pneumonia can cause pain in the upper abdomen. To rule out this a chest X-ray may be performed to make sure there are no other reasons for the abdominal pain.

Complications of Gallstone:

If the bile duct or duodenum are blocked by gallstones, the flow of digestive juices to the pancreas may be blocked which can cause jaundice and acute pancreatitis. Treatment usually involves the surgical removal of the gallbladder.
Blockage of a duct can also cause inflammation and ultimately severe pain, infection, and organ damage. Untreated gallstones may cause complications such as:

Cholecystitis:

This is infection in the gallbladder. The patient may have a fever and experience shivering in this condition.

Cholangitis:

In this condition the bile duct is infected.

Jaundice:

If the gallstone leaves the gallbladder and gets stuck in the bile duct it may block the passage of bile into the intestine. The bile will then enter into the bloodstream resulting a yellowish tint to your skin or eyes.

Biliary colic:

When a stone gets stuck in the opening of the gallbladder, and will not easily pass through, the contraction of the gallbladder may cause severe pain known as biliary colic. The pain is felt in the upper part of the abdomen, but can also exist in the center or to the right of the abdomen. Pain will be generated about an hour after eating, especially if the patient has had a high-fat meal. The pain will be constant and last a few hours, and then subside. Some patients will have pain for 24 hours which does not subside, while others may experience it for a short duration.

Sepsis:

The condition where the patient will have a blood infection.

Pancreas inflammation:

If the bile duct or duodenum are blocked by gallstones, the flow of digestive juices to the pancreas may be blocked which can cause acute pancreatitis. The pancreas is inflamed in this condition.

Gallbladder cancer:

Gallbladder cancer is the most common type of cancer found in the bile tract, and is more common in women and people older than 60.
In the majority of gallstone infection cases, the patient required hospitalization and have the gallstone surgically removed. People who have had their gallbladder removed may experience feelings of bloating and indigestion, especially when they have a high-fat meal. Some may pass stools more often than before.


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