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.
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VITAL SIGNS Volume 12 • Issue 2
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