Paper II
Question
Complications of gallstones
Answer
Complications of gallstones (cholelithiasis):
- Acute and chronic cholecystitis — inflammation of the gallbladder due to obstruction of the cystic duct.
- Biliary colic — pain from transient stone obstruction of the cystic or bile duct.
- Choledocholithiasis — stone migration into the common bile duct, causing obstructive jaundice.
- Acute pancreatitis — from obstruction at the ampulla of Vater.
- Ascending cholangitis — bacterial infection of the biliary tree secondary to obstruction.
- Gallbladder empyema — pus accumulation within an obstructed gallbladder.
- Gallbladder perforation with localized abscess or bile peritonitis.
- Gallstone ileus — mechanical bowel obstruction from a large stone eroding through a cholecystoenteric fistula into the bowel lumen.
- Mirizzi syndrome — extrinsic common hepatic duct obstruction from a stone impacted in the cystic duct/gallbladder neck.
- Increased risk of gallbladder carcinoma with long-standing, chronic cholelithiasis (particularly with a “porcelain gallbladder”).