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Gallstone disease (Cholelithiasis) - pathogenesis, prevention and contemporary methods of imaging diagnostics

Bistra Velchovska, Zhenya Zhekova-Maradzhieva, Atanas Uzunov, Evgeniya Ivanova, Desislava Petrova, Mariana Yordanova, Georgi Valchev


INTRODUCTION: Cholelithiasis is a metabolic disorder, leading to stone formation in the bile ducts and gall­bladder. The stones are classified by their composition as cholesterol, pigment, and mixed. The condition is more frequent in overweight individuals, with a stationary way of life, diabetics, and women on oral contracep­tives. There is a female predilection with a 3.5:1 ratio. The disease has several forms. The latent one is devoid of complaints - stones are an incidental finding. The acute form manifests with right upper quadrant pain. Bili­ary colic is typical - it comes in fits of right subcostal pain, nausea, and frequently - vomiting. Complications are frequent - gallbladder and bile duct inflammation, biliary obstruction, gallbladder perforation, and bili­ary peritonitis.

AIM: To analyze the pathogenesis, the prevention and the modern medical imaging methods related to the gallstones disease.

MATERIALS AND METHODS: This research applied statistical methods. The data was processed through sta­tistical and graphical analysis.

RESULTS: Accurate diagnosis requires a compound approach. Anamnesis of biliary colic initiates it. Abdomi­nal ultrasonography is the fastest and most accessible imaging method for finding gallstones. It can also pres­ent the gallbladder itself - whether it is enlarged, inflamed, or folded. Additional methods include magnetic resonance imaging (MRI), computed tomography (CT), and some hybrid techniques. If the data of cholelithi­asis is ambiguous, the latter can be confirmed by endoscopic retrograde cholangiopancreatography (ERCP) - an endoscope is introduced to the level of the papilla of Vater, and contrast is injected into it. The biliary path­ways also used to be imaged by percutaneous transhepatic cholangiography, which now is a dated technique.

CONCLUSIONS: Prophylaxis includes avoiding risk factors of alimentary nature and undergoing periodic con­trol ultrasonographies, especially in individuals with a family history of gallstones. This is crucial, as chronic

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About The Authors

Bistra Velchovska
Medical University of Varna

Student, TRS X-Ray Laboratory Assistant, Medical College

Zhenya Zhekova-Maradzhieva
Medical University of Varna

Student, TRS X-Ray Laboratory Assistant, Medical College

Atanas Uzunov
Medical University of Varna

Student, TRS X-Ray Laboratory Assistant, Medical College

Evgeniya Ivanova
Medical University - Sofia

Student, TRS Assistant Pharmacist, Yordanka Filaretova Medical College

Desislava Petrova
Medical University of Varna

Student, TRS Assistant Pharmacist, Medical College

Mariana Yordanova
Medical University of Varna

TRS X-Ray Laboratory Assistant, Medical College

Georgi Valchev
St. Marina University Hospital, Varna

Department of Radiology

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