Early Recognition Of Gallstones- What Is The Way?

Gallstones are within the bile ducts with small, large, or biliary stones located in the liver or outside the liver, in the gallbladder. The disease can cause biliary peritonitis, septic shock, gastrointestinal bleeding ... very dangerous

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Two types of gallstones are often formed: cholesterol and bile pigments. In Vietnam and Southeast Asian countries often meet this type of gravel. The reason is caused by roundworm eggs or corpses' "kernel" for bile pigment and calcium to cause stones If the roundworms on the bile ducts it causes infection and increased pressure in the bile ducts, causing scarring sores and then narrowing of the cirrhosis in the branches of the liver lobes, the upper bile duct is enlarged, bile is gradually deposited, thereby forming gallstones.




Manifestations of gallstones disease
A person with gallstones will have the following symptoms: abdominal pain with pain in the lower right flank (HSP), type of liver cramps, usually after a high fat meal, severe night pain about 23 - 24 hours ; when pain is accompanied by vomiting, the patient does not dare to breathe strongly; The pain lasts a few hours to a few days.
- Gastrointestinal disorders: dyspepsia, abdominal distention, patients fear of fat, constipation or diarrhea after meals. Migraine, severe migraine, when there is a lot of vomiting.
Fever due to inflammation of the bile ducts, gallbladder, high fever suddenly lasts several hours fever and HSP pain go hand in hand, if the pain is high the fever is high; sometimes the fever lasts a few weeks, every month; sometimes mild fever 37.5 - 380C; If there is no inflammation, no fever.

Jaundice and mucosa occur after pain and fever 1-2 days; jaundice-style jaundice including skin, yellow mucosa, yellow urine, and fecal feces; jaundice with itching, non-itchy anti-pruritus, slow pulse; Jaundice disappears more slowly than pain and fever.
- Three conditions: pain, fever, jaundice called Charcot's relapse many times, the interval between weeks, months, years

Examination: liver enlarged evenly, the level from teething under the flank to 5-6cm below the flank depending on the degree of biliary obstruction; smooth liver, firm density, bank, painful pressure.




- A large gallbladder with a large liver, a large gallbladder, painful to touch, may have HSP spasticity. Blood test: total bilirubin increases. Ultrasound shows gallstones, gallbladder stones. Take X-ray film and see gravel.
In fact, there are three main forms of disease as follows: one is a typical case of Charcot's triad, biliary obstruction syndrome, recurrent disease, with the above symptoms correctly diagnosing gallstones 60-75%.
- Two are atypical clinical symptoms: there is pain in the liver, no jaundice, no obstruction; or obstructing bile but not cramping.
Ba was a patient with stones but had to go to the emergency room for complications such as biliary peritonitis with signs of severe bacterial infection, hard abdomen, jaundice; septic shock; fever, big gallbladder, pain; gastrointestinal bleeding: vomiting-shaped blood resembling a pencil lead; acute abdominal pain, vomiting, abdominal distention.
Note in treatment and prevention
The use of antibiotics against infections is very important in the treatment of cholangitis.



It is best to rely on antibiotics to use drugs both effective and shorten the duration of illness for patients.
In case of not making antibiotics, it is necessary to use antibiotics with wide-spectrum and high-dose antibiotics such as colistin, cephalosporin, ampixillin, gentamyxin ... Muscle relaxants, spasms such as atropine, spasmaverin ...; bile medicines such as magnesium sulfate, artichoke syrup, sorbitol .



..; medications to dissolve stones in cases of small stones less than 2cm, the gall bladder is still good, patients can not be operated, or to prevent recurrence of stones after surgery.
Surgery in the following cases: stones that cause necrotic cholecystitis, cholangitis, acute pancreatitis, severe pain that result in ineffective analgesics, biliary tract bleeding, threatening biliary abscess, inflammation prolonged biliary tract, prolonged biliary obstruction, recurrence many times, gallbladder stones ... Get stones through duodenoscope ..



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Patients with gallstones need to follow a reasonable diet that is: abstain from fat, especially the type of animal fat such as cow, chicken, pig ... Eat reduced calories: eat only 2,000 calories / 24 hours. Drinking herbal medicines that support treatment of diseases such as mineral water, bare water, artichoke.
Prevention of gallstones disease should take the following measures: periodic medical examinations to promptly detect and treat diseases that cause gallstones, such as diseases in the last intestine, reduce absorption of bile salts, dyslipidemia ; control diet against obesity; avoid eating high-calorie diets; avoid using estrogen drugs to treat people with pre-existing gallstones; once every 6 months deworming, eat boiled and cooked to avoid worm infection..

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