Predisposing Precipitating Factors:

Factors:
Assaz Faulty Diet
Obesity
Advanced Age Pregnancy
Gender Frequent Starvation and
Ileal Prolonged parenteral
Resection/Disease nutrition.
Race

Decreased Increased level of

level of fat
Bile the blood stream
Acids
↑ Synthesis of bile
in the liver.

↑ Excretion of
Cholestrol to the
bODY.

Ratio of bile salts & lecithin

with
cholesterol is no longer
within the

Cholesterol concentration
>
solubility capacity of the

No formation of mixed
miccelles
 Lithogenic bile/
supersaturated bile
(creamy)

Mucoprecipitates of organic& inorganic

calcium salts become nucleation sites

Nucleation and production of

cholesterol monohydrate crystals

Large cholesterol
stones

Extrusion of stones from

Gallbladder

Impaction of cystic and

Distention of biliary tree

Bile not excreted to
and
fundus of gallbladder Backflow of bile and goes to
the
Forceful
contractions
of
gallbladder
↑ levels of bilirubin/bile ↓ conversion of
bilirubin to
pigments
Spasm of urobilinogen in
smooth in the circulation the No absorption of
muscle in intestines fat in
the ducts
↓ excretion of
↑ Renal secretion urobilinogen in Nausea
of stool and
PAIN Vomiting
Fullnes
PALE
Jaundice, DARK
Indigestion
STOOL Vit. ADEK
Pruritus URINE