RT Book, Section
A1 Paumgartner, Gustav
A1 Greenberger, Norton J.
A2 Greenberger, Norton J.
A2 Blumberg, Richard S.
A2 Burakoff, Robert
SR Print(0)
ID 1119991678
T1 Gallstone Disease
T2 CURRENT Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy, 3e
YR 2016
FD 2016
PB McGraw-Hill Education
PP New York, NY
SN 9780071837729
LK accessmedicine.mhmedical.com/content.aspx?aid=1119991678
RD 2024/04/25
AB ESSENTIAL  CONCEPTSMajor  risk  factors  for  cholesterol  gallstones  include  age  >50,  female  sex,  Native  American  or  Mexican  ethnicity,  genetic  predisposition,  family  history,  pregnancy  and  parity,  estrogens,  obesity,  and  the  metabolic  syndrome.Gallstones  are  often  found  incidentally  during  abdominal  ultrasonography,  which  has  >95%  sensitivity  for  cholesterol  stones  ≥1.5  mm.In  ~80%  of  cases  gallstones  remain  asymptomatic;  in  symptomatic  patients,  biliary  colic  is  almost  always  present,  often  radiating  to  the  right  scapula  or  shoulder.Laparoscopic  cholecystectomy  is  indicated  in  patients  with  symptomatic  gallstones.Major  complications  of  gallstone  disease  requiring  treatment  are  acute  cholecystitis,  choledocholithiasis,  obstructive  jaundice,  cholangitis,  and  pancreatitis.Acute  cholangitis  caused  by  an  obstructing  gallstone  should  be  treated  by  endoscopic  removal  of  the  stone  under  antibiotic  coverage  as  soon  as  possible.