Karnataka PGET Surgery MCQ Answer 27

• Gallstones are found in 12% men and 24% women
• Prevalence increases with advancing age
• 10-20% become symptomatic
• Over 10% of those with stones in the gallbladder have stones in the common bile duct

• Three types of stones are recognised

• Cholesterol stones (15%)
• Mixed stones (80%)
• Pigment stones (5%)

• Mixed stones are probably a variant of cholesterol stones
• 10% of gallstones are radio-opaque
• Cholesterol stones result from a change in solubility of bile constituents
• Bile acids act as a detergent keeping cholesterol in solution
• Bile acids, lecithin and cholesterol result in the formation of micelles
• Bile is often supersaturated with cholesterol
• This favours the formation of cholesterol microcrystals
• Biliary infection, stasis and changes in gallbladder function can precipitate stone formation
• Bile is infected in 30% of patients with gallstones
• Gram-negative organisms are the most common isolated

• Acute cholecystitis
• Empyema of the gallbladder
• Mucocele of the gallbladder
• Biliary colic
• 'Flatulent dyspepsia'
• Mirrizi's syndrome
• Obstructive jaundice
• Pancreatitis
• Acute cholangitis

Category: Karnataka PGET 2007 MCQs