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Digestive system	Cholecystolithiasis	Gallstones, cholangiogram	Kidney cyst with gallstones, CT scan
Cholelithiasis	Gallbladder	Gallbladder	Gallbladder removal - series

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Overview	Symptoms	Treatment	Prevention

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Gallstones

Alternative Names

Cholelithiasis

Symptoms

Symptoms usually start after a stone of sufficient size (larger than 8mm) blocks the cystic duct or the common bile duct. The cystic duct drains the gallbladder, and the common bile duct is the main duct draining into the duodenum. Collectively, these ducts form part of the biliary system.

A stone blocking the opening from the gallbladder or cystic duct usually produces symptoms of biliary colic, which is right upper quadrant abdominal pain that feels like cramping. If the stone does not pass into the duodenum, but continues to block the cystic duct, acute cholecystitis results.

If the common bile duct is blocked for a substantial period of time, bacteria may find their way up behind the stone and grow in the stagnant bile, producing symptoms of cholangitis. Cholangitis is a serious condition and usually requires hospitalization. Continued blockage of normal bile flow may produce jaundice.

Stones blocking the lower end of the common bile duct where it enters the duodenum may obstruct secretion from the pancreas, producing pancreatitis. This condition can also be serious and may require hospitalization.

In general, pay attention to the following symptoms:

• Abdominal pain in the right upper quadrant or in the middle of the upper abdomen, which:
  • May be recurrent
  • May be sharp, cramping, or dull
  • May radiate to the back or below the right shoulder blade
  • May be made worse by fatty or greasy foods
  • Occurs within minutes of a meal
• Jaundice
• Fever

Additional symptoms that may be associated with this disease include:

• Clay-colored stools
• Nausea and vomiting
• Heartburn
• Gas or excessive flatus
• Abdominal indigestion
• Abdominal fullness, gaseous

Exams and Tests

There are numerous tests to detect the presence of gallstones or gallbladder inflammation:

• Abdominal ultrasound
• Abdominal CT scan
• Abdominal x-ray
• Oral cholecystogram
• Gall bladder radionuclide scan
• ERCP (endoscopic retrograde cholangiopancreatography)

This disease may also alter the results of the following tests:

• Fecal fat quantitation
• Urine bilirubin
• Abdominal MRI

Review Date: 10/9/2003
Reviewed By: Christian Stone, M. D., Division of Gastroenterology, Washington University in St. Louis School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network.

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