CHOLELITHIASIS

Gallstones in the Bile duct

Increased Bile Cholesterol

Calcium Bilirubinate

Irritation of Gallbladder

Precipitate out of the bile Forms small crystals into Gallbladders mucosal surface

Irritation of Gallbladder

Combines with stearic acid, Lecithin and palmitic acid

Surface Changes

Pigment Stones

Increased Mucus Secretion Enlarges to grossly visible stones Impaired Gallbladder emptying Several stones develop Forms Brown Gallstones

Obstruction Contractile function Distension Intraductal Pressure RUQ Pain Injury Bile accumulat es in Liver Release of Inflammatory Mediators Biliary Colic Mucosal Ischemia Increase Permeability of Blood Vessels Fluid, Proteins and Cells enter interstitial spaces Vit. K absorption Decrease bile flow Prorates/Teacollared Urine Increase Serum Bilirubin

Bile Stasis

Bacterial Proliferation

Abnormal Fat Digestion

Blood flow & Lymphatic drainage Is compromised

Gallbladder duct infection

Rupture of Gallbladder

Anorexia Nausea Vomiting Weight loss Flatulence Diarrhea Fat intolerance

Necrosis

Peritonitis

Edema

Jaundice

Biliary Cirrhosis

Inflammation of Gallbladder

Cholecystitis

Increase WBC

Release of Pyrogens

Leukocytosis

Increased Hypothalamic set point

Inflammation of Gallbladder