Gall Bladder Stone

Gall Bladder Stone

The gall bladder is a storage place for digestive (bile) juice. It is tucked below the liver, in the right upper side of the abdomen. When you consume fatty foods, the gall bladder pushes bile juice into the intestine through the bile duct, to aid digestion.

Any changes in the bile juice can result in formation of small pebble like stones in the gallbladder, commonly called as gallstones or gallbladder stones.

Gallstones can either be as big as golf ball or as small as a pebble. Also, there can be one large stone or many small stones or a combination of both.

Definition

Gallstones (Cholelithiasis) usually form in the gallbladder from the solid constituents of bile and vary greatly in size shape and composition.

Types

The two main kinds are

•               Cholesterol stones. These are usually yellow-green in color. They're the most common kind, accounting for 80% of gallstones.

•               Pigment stones. These stones are smaller and darker. They're made up of bilirubin, which comes from bile, a fluid your liver makes and your gallbladder stores.

Risks Factors

•               Pregnant women and those who are on birth control pills

•               People of age >40 years

•               Obese people

•               People undergoing sudden weight loss

•               Those with a positive family history of gallstones

•               Individuals with health issues such as diabetes and certain intestinal and liver diseases

•               Patient with Cirrhosis, hemolysis and infections of the biliary tree.

•               Warning signs of a serious problem are fever, jaundice, and persistent pain.

Signs and Symptoms

•               Asymptomatic even for years

•               Fullness

•               Abdominal distension

•               vague pain in the right upper quadrant of the abdomen.

•               Reffered Pain and Billary Colic

•               Jaundice

•               Vitamin Deficiency- A, D, E and K

Diagnosis

•               Abdominal X-ray

•               Ultrasonography

•               Cholescintography

•               Cholecystography

•               Percutaneous Transhepatic cholangiography (PTC)

•               Serum bilirubin and phosphatase

Nursing management

•               Dissolving Gallstones by infusion of a solvent into the gall bladder.

•               Two types of non-surgical or noninvasive treatment options can be used to dissolve cholesterol gallstones:

•               In laparoscopic cholecystectomy, the gall bladder is removed through a tiny slit in the abdomen with the help of a tiny video camera. The recovery is faster and patient can be discharged on the next day.

•               Open cholecystectomy is performed when laparoscopic cholecystectomy is not possible. Open surgery causes more pain and recovery time in hospital is around a week.

•               Extra Corporeal Shock-Wave Lithotripsy (ECSW)

Supportive Management

•               Intravenous fluids administration

•               Nasogastric tube suction

•               Pain management

•               Antibiotics

Complication

•               Cholangitis

•               Necrosis

•               Gallstoneileus leads to intestinal obstruction