Parasites and Biliary stones

Gallbladder stones ٦٦
Complications of gall bladder stones:
- Obstruction of the cystic duct or neck of the gall bladder. Mucocele if
the contents are sterile.
- acute cholecystitis with or without empyema, gangrene, or perforation
of the gall bladder.
- Chronic calcular cholecystitis: the gall bladder is usually thick wall
and is commonly, contracted.
- Carcinoma of the gall bladder due to squamous metaplasia in long
standing cases.
Diagnosis:
(Schwartz, 2005)
Symptoms (biliary colic): Symptoms usually start after a stone of
sufficient size (larger than 8 mm) blocks the cystic duct.Characterized by:
Fever, abdominal pain in the right upper abdomen or in the middle of the
upper abdomen, which is recurrent, sharp, cramping, or dull, radiating to
the back or below the right shoulder blade, worsen by fatty or greasy
foods, and occurs within minutes of a meal. Additional symptoms that
may be associated with this disease include, nausea, vomiting, heartburn
and abdominal indigestion and fullness (Houchen, 2005).
Physical examination (signs):
During attacks of biliary colic, patients have tenderness to palpation
over the gallbladder. This can be elicited by having the patient inhale
while the examiner maintains steady pressure below the right costal
margin (Murphy's sign). Localized rebound tenderness, guarding, or
rigidity may occur. The Charcot's triad of severe right upper quadrant