Vital Signs VitalSigns2_2017 | Page 5

What is a gall stone made of? Our thanks to Dr. Russell Williams for sharing his time and expertise on these procedures. There are cholesterol stones and bile-pigment stones. There are three components to bile: cholesterol, bile salts and lecithin. If any one of the three get out of whack, you form stones. Most are cholesterol stones, though it has nothing to do with your cholesterol level. It’s just that the ratio is wrong. Gall stones are more common in women due to changes in estrogen. A lot of women during pregnancy will form stones, and some come in with gall stones within a year of giving birth. Some people form bile pigment stones. For example, if you have sickle cell and your red cells break down, then your bile salt component goes up. So, you end up forming these pigment stones. The other thing that can happen is that when some people form stones, they’ll come in to the ER with jaundice, having pain and nausea. That’s because sometimes those gall stones will pass from the gall bladder to the main bile duct which empties into the small intestine. They get lodged there and it backs up which causes jaundice. I routinely inject dye into the duct drain to make sure there’s good flow and no blockages. You wouldn’t want to leave the stones in there because they can wreak havoc. Dr. Williams has practiced general surgery in Louisville for 27 years and is affiliated with Associates in General Surgery. I usually tell my patients that I’m going to x-ray their bile duct. Some surgeons do it on a case-by-case basis. I do it routinely for a couple reasons. One: to make sure everything’s normal and two: sometimes there’s an anatomic variant we may not know about and checking can keep you out of trouble. It can help define the anatomy. There’s not too much of a downside of doing it. Have you enjoyed reading Vital Signs ? Get healthy tweets by following @VitalSigns2Go on Twitter. FIND US ON TWITTER OR TEXT @VitalSigns2Go VITAL SIGNS Volume 12 • Issue 2 follow VitalSigns2Go TO 40404. 5