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Gallstones: Risk Factors, Types & Clinical Presentation

by Carlo Raj, MD
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    Gallstones is where we’re at. There might be a genetic predisposition. If you see the letter F or derivatives of, is your patient a woman, a female, F? Is she in her reproductive age, fertile? Is she pregnant? Is she fat? Female, forty, fat, fertile, FFFF. The type of gallstone that you’re thinking, when the F criteria have been met, cholesterol, the most common. Now, with all that said, be careful though, okay? You want to take a look at the history of your patient. If there’s a history in which there’s bilirubin, let’s say for example, sickle cell disease, how much bilirubin is being released? Whew, a lot, right? And if it’s bilirubin that is accumulating, giving rise to a stone in the gallbladder, why would you call that a cholesterol stone? Do you see what I’m saying? So percentage-wise, sure, as long as you meet the criteria, but be careful. Pay attention to history. Risk factors; octreotide, ceftriaxone, OCP, prolonged TPN, and ileal disease causing bile acid malabsorption. For example, remember where intrahepatic circulation takes place? In the terminal ileum. If there are indications for, perhaps, for removing parts of terminal ileum, there’s every possibility that results in bile acid malabsorption. Therefore, increases of the risk of gallstones cholesterol type. Two types, the type we just talked about, cholesterol -- FFFF, female, forty, fat, fertile. Pigment, I gave an example, Sickle cell disease, increased extravascular hemolysis. You have unconjugated bilirubin, and the bilirubin may also accumulate within the gallbladder. With the gallstone, what’s the kind of pain that the patient's going to feel? Postprandial. What kind of meal? “Hey, doc. I just had a cheeseburger.” Great. "After a cheeseburger, how did you feel?” “Whoa, a pain. Shooting right here, right upper quadrant." On a scale of one to...

    About the Lecture

    The lecture Gallstones: Risk Factors, Types & Clinical Presentation by Carlo Raj, MD is from the course Pancreatic and Biliary Tract Diseases.


    Author of lecture Gallstones: Risk Factors, Types & Clinical Presentation

     Carlo Raj, MD

    Carlo Raj, MD


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