Cholelithiasis
Cholelithiasis is the presence of one or more stones (lithiasis) in the gallbladder.
It is relatively frequent. In Western countries, approximately 10% of adults and 20% of those over 65 years of age have gallstones. Gallstones are usually asymptomatic in most cases(approximately 80%).
When they produce symptoms (remaining 20%), the most frequent symptom is biliary colic, which typically presents with acute pain in the right upper quadrant of the abdomen and may be accompanied by nausea and vomiting. Attacks of pain usually last less than 6h but can last up to 12h. The pain is usually severe enough to require emergency care. It usually subsides with the administration of analgesics.
Complications
Cholelithiasis can also lead to more serious complications such as:
– Acute calculous cholecystitis (infection and inflammation of the gallbladder).
– Choledocholithiasis (obstruction of the bile ducts by stones in the main bile ducts, which may be accompanied by infection (acute cholangitis)).
– Acute lithiasic pancreatitis (pancreatic inflammation due to the effect of stones).
These complications require hospital admission and sometimes urgent surgery.
There is a risk of developing symptoms of cholelithiasis of approximately 2% per year. The most common initial symptom is biliary colic, although it can sometimes debut with major biliary complications, such as those mentioned above. When cholelithiasis begins to produce symptoms, it is likely to continue to cause problems. Between 20 and 40% of patients re-experience colic within one year, with 1 to 2% of major complications per year.
Risk factors for the development of gallbladder stones are female sex, overweight, age over 40 years, Indo-American ethnicity, high-fat diet, rapid weight loss and family history.
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Diagnosis is usually carried out with ultrasound, although sometimes CT or MRI scans are necessary.
If cholelithiasis causes symptoms or complications, cholecystectomy is indicated, unless the very high surgical risk makes it inadvisable.
In some cases (large stones, multiple millimetric stones or porcelain or scleroatrophic gallbladder), or by patient’s choice, surgery without symptoms may be indicated.
If lithiasis is detected in the main bile duct (choledocholithiasis), it is usually removed by an endoscopic technique called ERCP (endoscopic retrograde cholangiopancreatography) before gallbladder surgery.
Cholecystectomy (removal of the gallbladder) is performed laparoscopically in the vast majority of cases today. As it is a minimally invasive surgery, recovery is usually very fast, with an overnight stay. Rarely, it may be necessary to convert to conventional open surgery or to use the open approach at the outset.
Frequently Asked Questions
about Pilonidal Sinus
- Reddening of the skin
- Pain
- Presence of pus or blood in an opening of the skin.
- Unpleasant odor of oozing pus.
This pathology should be treated by a specialist in coloproctology, which is responsible for the diagnosis and treatment of diseases of the colon, rectum and anus.
As we know, the pilonidal cyst is located in the region above the intergluteal fold, an area of treatment for this specialist.
