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ASKEP KLIEN DG

CHOLELITHIASIS

Nursiswati

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Cholelithiasis, is a relatively common disease,

over 10% of the adult population of European

countries have this disease. In most cases,

cholelithiasis is discovered during a routine

abdominal ultrasound, but also can give

symptoms.

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The main causes incriminated in the

development of cholelithiasis are:

Genetic predisposition;

Female gender: the ratio women / men being2-3/1;

Obesity;

Age;

Dyslipidaemia;

Diabetes;

Hypertriglyceridaemia.

http://www.doctortipster.com/1410-obesity-risk-factors-complications-and-associated-diseases.htmlhttp://www.doctortipster.com/14-what-is-diabetes-what-are-the-types-of-diabetes-2.htmlhttp://www.doctortipster.com/14-what-is-diabetes-what-are-the-types-of-diabetes-2.htmlhttp://www.doctortipster.com/1410-obesity-risk-factors-complications-and-associated-diseases.html

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Pathogenesis

Cholelithiasis, occurs as a consequence ofbreaking the existing balance in the bile, wherecholesterol, bile acids and lecithin are in abalance that ensures cholesterol solubilisation.

An increase in the elimination of cholesterol (indyslipidemia, the sudden loss weight, diabetes,obesity) or on the contrary, a decrease in bile acidsecretion will lead to breaking the balance that

ensures cholesterol solubilisation at itsprecipitation in the gallbladder, with cholesterolcrystals development. Biliary stasis is anotherfactor that favors the appearance of gallstones.

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Classification of cholelithiasis:

A modern concept of cholelithiasis is theclassification in:

Symptomatic cholelithiasis, it is the one thatgenerates biliary colic. Biliary colic represents aintense or violent pain in the epigastrium or righthypochondrium , lasting about 30 minutes.Nausea, vomiting and headache, occurring inoutside of biliary colic, dose not represent

symptomatic cholelithiasis. Asymptomatic cholelithiasis is the form of the

disease that does not cause biliary colic.

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Complications of cholelithiasis

Biliary colic;

Acute cholecystitis;

Migration of gallbladder stones in coledoc; Vesicular hydrops;

Acute pancreatitis;

Gallbladder cancer.

http://www.doctortipster.com/1179-acute-cholecystitis-causes-and-symptoms.htmlhttp://www.doctortipster.com/1179-acute-cholecystitis-causes-and-symptoms.htmlhttp://www.doctortipster.com/1179-acute-cholecystitis-causes-and-symptoms.html

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TREATMENT

Non-surgical treatment techniques of cholelithiasis are druglitholysis and shock wave lithopripsy, less used lately due to thehigh degree of occurrence of the relapse.

Drug litholysis is addressed to cholesterol gallstones, preferablysmall. Treatment consists of administration of ursodeoxycholic acid

or combined with chenodeoxycholic acid, for a period of 3 to 12months, until the complete dissolution of gallstones apper. Chanceof success is about 50% and the risk of relapse within 5 years is10%. Supervision is done by abdominal ultrasound.

Shock Wave Lithotripsy, consists in bombing of cholesterol stoneswith shock waves. It is addressed to unique gallstones or less

numerous stones, preferably less than 15 mm. Fragments will bedissolved by the administration of bile acids (ursodeoxycholic acid),up to complete disappearance of all fragments of stones from thegallbladder.

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The prognosis of cholelithiasis:

Cholelithiasis has often a good prognosis

because symptomatic cases are most often

solved by surgery and the asymptomatic

forms are kept under surveillance.

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THANKS