Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

• In the US and Europe, involves 10-20% of the population (something in the range of 30 million people).
• The total weight of the stones is estimated at between 25 and 50 tons!
• Most gallstones are silent.
• Two basic types(1) those composed of bile salts and cholesterol monhydrate, and (2) those composed of bilirubin calcium salts (also known as pigment stones).
• Cholesterol stones occur in up to 75% of certain Native American groups.
• Among caucasians, the old adage is: female, fertile, fat, fair and forty. It largely holds.
• Incidence increases as you age.
• Increased secretion of bile cholesterol is the big factor.
• Drugs that increase bile cholesterol, estrogens, Clofiberate, increase chances of stones.