PATHOPHYSIOLOGY

Precipitating Factors:
Predisposing Factors: Female Age 38 Ethnicity Diabetes Mellitus

Bile stagnates in the gallbladder

Birth control pills Low Fat Diet Pregnancy Rapid weight loss Obesity fasting

Pigment solute precipitate as solid crystals

Crystals clump together and form stones Gallstones

Gallbladder contracts after intake of fat to release bile

Upon contraction, a stone is moved and becomes impacted on the cystic duct

CHOLELITHIASIS

Lumen is obstructed by stones

Bile stasis

Chemical reaction inside gallbladder triggers the release of inflammatory enzymes (Prostaglandins)

Fluids leak into gallbladder Edema

Inflammation of the gallbladder

Increased intraluminal pressure and distention of the gallbladder

Biliary Colic (RUQ pain)

Constriction of blood vessels

Murphys Sign

ACUTE CHOLECYSTITIS
If not treated If treated with: Continued lack of blood supply to gallbladder Continued increase in intraluminal pressure of gallbladder

Surgery, proper diet (low fat, high fiber), compliance to medications

Necrosis Rupture of gallbladder

Good prognosis

Gangrene and empyema Spread of bile indigenous microorganisms peritoneal cavity and into

Perforation of gallbladder

Sepsis

Death