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What Does Multiple Partially Calcified Gallstones With Gallbladder Wall Hyperemia Indicate?
Question: Hello. After 10 days of relatively mild discomfort in flank and right abdomen but no fever, chills, or nausea, test showed blood in urine (only visible in morning). Did ab/pelvic CT scan and found 'Multiple partially calcified gallstones with a mild degree of gallbladder wall hyperemia. No common bile duct dilation.' That was the only finding - everything else was clear. Have been referred for gallbladder removal. Two questions: 1) Aside from being female, 46, and fertile, I have no risk factors and am healthy and active. Am thin, rarely eat meat, avoid processed sugar, gluten, and bad fats, etc. I have been hypothyroid for 14 years now, but it's under control with Synthroid and all tests are always within range. So.....what the heck? Could the fact that gallstones formed indicate another underlying problem or did I just draw the short straw on this one? And 2) Given that all symptoms are still very mild with no fever, chills, nausea, and that this is my first 'attack' and it's causing only minor disruption (still going to work, etc. but bit more fatigued and have core muscle fatigue) is it reasonable to jump right to surgery? Thanks Doc - appreciate your time and help.
Brief Answer:
surgery should be considered
Detailed Answer:
Hello,
the decision to remove the gallbladder because of gallstones depends on various factors. First of all, if the doctor were certain that this was a biliary colic then you've got symptomatic gallstones, which is a clear indication for surgery (not an urgent one though). Even if your symptoms had nothing to do with the gallstones, there are still arguments for surgery. 1 out of 4 patients will develop symptoms within the next decade (and every decade), so taking into account your age, this is something to consider.
Besides that the size of the stones is also relevant. Large (diameter more than 2cm) gallstones are also an indication.
The fact that you live a healthy life is great regarding formation of new stones but questions are raised about the current ones. For example a chronic anemia may cause the formation of gallstones. If you do have a reason to form stones then perhaps your doctor should consider dealing with it too.
The most dreaded complication of the presence of gallstones is acute pancreatitis. Acute pancreatitis may occur when the gallstones leave the gallbladder and move around the bile duct. When they do, symptoms may occur like pain, jaundice, dark urine, etc and various lab tests altered like increased bilirubin, increased SGOT (AST), etc.
The latter is particularly useful in diagnosing a biliary colic. If you did have an elevated SGOT then it's very likely that a stone passed through your bile duct and you were at risk for pancreatitis... This would be too dangerous to ignore.
Besides the strictly medical opinion, I do believe that your doctors have considered all the above before advising you.
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
surgery should be considered
Detailed Answer:
Hello,
the decision to remove the gallbladder because of gallstones depends on various factors. First of all, if the doctor were certain that this was a biliary colic then you've got symptomatic gallstones, which is a clear indication for surgery (not an urgent one though). Even if your symptoms had nothing to do with the gallstones, there are still arguments for surgery. 1 out of 4 patients will develop symptoms within the next decade (and every decade), so taking into account your age, this is something to consider.
Besides that the size of the stones is also relevant. Large (diameter more than 2cm) gallstones are also an indication.
The fact that you live a healthy life is great regarding formation of new stones but questions are raised about the current ones. For example a chronic anemia may cause the formation of gallstones. If you do have a reason to form stones then perhaps your doctor should consider dealing with it too.
The most dreaded complication of the presence of gallstones is acute pancreatitis. Acute pancreatitis may occur when the gallstones leave the gallbladder and move around the bile duct. When they do, symptoms may occur like pain, jaundice, dark urine, etc and various lab tests altered like increased bilirubin, increased SGOT (AST), etc.
The latter is particularly useful in diagnosing a biliary colic. If you did have an elevated SGOT then it's very likely that a stone passed through your bile duct and you were at risk for pancreatitis... This would be too dangerous to ignore.
Besides the strictly medical opinion, I do believe that your doctors have considered all the above before advising you.
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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