Recent study on gallstones

November 27, 2004

This was published only a few days ago. I am

guessing the environment of the patients are

probably different from most peoples' reading

this, but I found it interesting nonetheless.

Link to full text at bottom.

World J Gastroenterol. 2004 Nov 15;10(22):3318-21.

Opisthorchiasis-associated biliary stones: Light and scanning electron

microscopic study.

Sripa B, Kanla P, Sinawat P, Haswell-Elkins MR.

Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon

Kaen, 40002, Thailand. banchob@....

AIM: Biliary stones are frequently encountered in areas endemic for

opisthorchiasis in Thailand. The present study was to describe the

prevalence and pathogenesis of these stones.

METHODS: Gallstones and/or common bile duct stones and bile specimens from

113 consecutive cholecystectomies were included. Bile samples, including

sludge and/or microcalculi, were examined for Opisthorchis viverrini eggs,

calcium and bilirubin. The stones were also processed for scanning electron

microscopic (SEM) study. RESULTS: Of the 113 cases, 82 had pigment stones,

while one had cholesterol stones. The other 30 cases had no stones. Most of

the stone cases (76%, 63/83) had multiple stones, while the remainder had a

single stone. Stones were more frequently observed in females. Bile

examination was positive for O. viverrini eggs in 50% of the cases studied.

Aggregates of calcium bilirubinate precipitates were observed in all cases

with sludge. Deposition of calcium bilirubinate on the eggshell was

visualized by special staining. A SEM study demonstrated the presence of the

parasite eggs in the stones. Numerous crystals, morphologically consistent

with calcium derivatives and cholesterol precipitates, were seen.

CONCLUSION: Northeast Thailand has a high prevalence of pigment stones, as

observed at the cholecystectomy, and liver fluke infestation seems involved

in the pathogenesis of stone formation.

Recommended Posts