Chapter 43

Gallstones

Piero Portincasa

Piero Portincasa

University of Bari Medical School, Policlinico Hospital, Bari, Italy

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David Q.-H. Wang

David Q.-H. Wang

Albert Einstein College of Medicine, Bronx, NY, USA

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First published: 25 February 2022

Summary

This chapter offers diverse images that provide an overview of gallstones and aims to provide a synopsis through pictures and illustrations rather than through text. Gallstones are composed of cholesterol monohydrate crystals, mucin gel, calcium bilirubinate, and proteins in the biliary system. Based on chemical composition, gallstones are often classified into three types: cholesterol, pigment, and rare stones. Gallstones are discovered incidentally during different diagnostic tests in asymptomatic patients or when the typical biliary colicky pain or complications emerge. Besides the clinical presentation, imaging exams include abdominal ultrasonography, computed tomography, magnetic resonance cholangiopancreatography, and cholescintigraphy. Different guidelines have been developed for the treatment of gallstones. Gallstones remain asymptomatic in the vast majority of subjects, and under these circumstances, expectant management is the best choice.

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