Parasites and Biliary stones

Gallbladder stones ٦٧
tenderness with jaundice and fever is characteristic of ascending
cholangitis (Heuman, 2006).
Laboratory studies:
They are normal in the asymptomatic patient and patients with
uncomplicated biliary colic. An elevated white count should raise the
suspicion for cholecystitis or other infectious process. However, up to one
third of the patients with cholecystitis may not manifest leukocytosis.
Elevated transaminases levels indicate a hepatic process. An elevated
lipase is indicative of pancreatitis (Lee, 2006).
Imaging studies:
Plain radiography in these patients is of limited value because many
stones are not visible. Ultrasonography (US) is the least expensive, safest,
and most sensitive technique for visualizing the biliary system,
particularly the gallbladder. Current accuracy is close to 95% (Bonheur,
2006).
Radionuclide scanning are used to assess gall bladder function, its
ability to harbor and concentrate bile, and perhaps more importantly, its
motility response to cholecystokinin or a fatty meal by quantifying the
ejection fraction (Migala, 2006).
Treatment:
Medical care: Non-surgical management of gallstone disease is the use
of ursodeoxycholic acid (natural bile acid). One study demonstrated a
56% reduction in biliary pain after 3 months of therapy and a mean
dissolution of gallstones in 59% of cases after 12 months of treatment
with 10 mg/kg/day of ursodeoxycholic acid. The primary disadvantage
with this approach is the incidence of recurrent gallstones, approximately