Cholelithiasis

• Cholelithiasis

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- Formation or presence of stone in the gallbladder

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- Risk factor: 4 F (female, fat, forty, fertile)

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- Types of gallstones:

- Cholesterol stones – 50% cholesterol by wt

- Pigment stones – bile pigments often caused by stasis of bile

- - Clinical Manifestations

- Intolerance to fatty foods

- Nausea and vomiting

- Pain in right upper quadrant

- Positive Murphy’s sign

- Low grade fever

- Steatorrhea

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- Diagnostics:

- Cholecystogram, CT scan, Ultrasound

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- Elevated unconjugated bilirubin, WBC, Amylase, lipase

- Management

- Analgesics (demerol)

- Antiemetics

- Oral dissolution therapy- ursodeoxycholic acid

- Surgery:

- Extracorporeal Shockwave lithotrypsy

- Laparoscopic laser cholecystectomy

- Abdominal cholecystectomy

- Percutaneous cholecystolithotomy

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Nursing Interventions:

- Same as cholecystitis