Cholelithiasis, cholecystitis, and related disorders

Cholelithiasis, cholecystitis, and related disorders

Diseases of the gallbladder and biliary tract are common, typically painful conditions that usually require surgery and may be life-threatening. They’re commonly associated with deposition of calculi and inflammation. (See Common sites of calculus formation.)

In most cases, gallbladder and bile duct diseases occur during middle age. Between ages 20 and 50, they’re six times more common in women, but the incidence in men and women becomes equal after age 50. After that, incidence rises with each succeeding decade.


The origin and frequency of gallbladder and biliary tract disease vary with the particular disorder.


The presence of stones or calculi (gallstones) in the gallbladder results from changes in bile components. Gallstones are made of cholesterol, calcium bilirubinate, or a mixture of cholesterol and bilirubin pigment. They arise during periods of sluggishness in the gallbladder resulting from pregnancy, use of oral contraceptives, diabetes mellitus, Crohn’s disease, cirrhosis of the liver, pancreatitis, obesity, and rapid weight loss.

Cholelithiasis is the fifth leading cause of hospitalization among adults and accounts for 90% of all gallbladder and duct diseases. The prognosis is usually good with treatment unless infection occurs, in which case the prognosis depends on the infection’s severity and response to antibiotics.


Cholecystitis, an acute or chronic inflammation of the gallbladder, is usually associated with a gallstone impacted in the cystic duct; the inflammation develops behind the obstruction. Cholecystitis accounts for 10% to 25% of all patients requiring gallbladder surgery.

The acute form is most common during middle age; the chronic form,
among elderly people. The prognosis is good with treatment.

Biliary cirrhosis

Primary biliary cirrhosis is a chronic, progressive disease of the liver characterized by autoimmune destruction of the intrahepatic bile ducts and cholestasis. This condition usually leads to obstructive jaundice and pruritus and involves the portal and periportal spaces of the liver. It affects women between the ages of 40 and 60 nine times more often than men. The prognosis is poor without liver transplantation.


An infection of the bile duct, cholangitis is commonly associated with choledocholithiasis and may follow percutaneous transhepatic cholangiography. Predisposing factors include bacterial or metabolic alteration of bile acids. Widespread inflammation may cause fibrosis and stenosis of the common bile duct. The prognosis for this rare condition is poor without stenting or surgery.

Only gold members can continue reading. Log In or Register to continue

Jun 16, 2016 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Cholelithiasis, cholecystitis, and related disorders

Full access? Get Clinical Tree

Get Clinical Tree app for offline access
%d bloggers like this: