Complications of Gallstones
Asymptomatic gallstones do not or very rarely cause complications. However people with untreated, symptomatic gallstones might develop serious complications which could also be life threatening. Complications caused by gallstones in the gallbladder are:
Acute Cholecystitis: It is an acute inflammation of the gallbladder. In some people the gallstones together with bile might end up irritating the inner wall of the gallbladder itself. This irritation, inflames the gallbladder and the person may develop pain in the upper abdomen, which goes to the back and tip of the right shoulder, with the pain lasting for hours to days. Patients also have nausea and vomiting, fever, tachycardia (rapid heartbeat) and tenderness in the abdomen. If left untreated it might lead to further complications like empyema (pus) of the gallbladder, a perforation or tear in the gallbladder and very rarely gangrene of the gallbladder.
Chronic Cholecystitis: Continuous irritation of the gallbladder over time leads to chronic inflammation, in this condition there is scarring and shrinkage of the gallbladder.
Carcinoma of Gallbladder: Cancer of the gallbladder is very rare, but it has been found that 80% of the patients with cancer had gallstones present in them. It is detected quite late and along with pain the patient exhibits weight loss, anaemia, vomiting and lump in the abdomen.
Complications arising from gallstones present in the common bile duct are:
Obstructive Jaundice: It develops when a biliary stone is blocking the duct. Bilirubin is excreted from the body through faeces or stools. If there is an obstruction the bilirubin stays inside the body and its level increases in the circulating blood. Increased levels of bilirubin can cause:
Acute Pancreatitis: Stones lying near the ampulla of Vater may interfere with the drainage of pancreatic enzymes into the duodenum and along with bile reflux it might lead to inflammation of the pancreas. Patients develop fever, very severe pain around the umbilicus which goes directly to the back, vomiting, tenderness of the abdomen and jaundice.
Ascending Cholangitis: Obstruction of the bile duct leads to high risk of developing bacterial infection. If untreated, the infection spreads from the ducts to the gallbladder and to the liver (hence the term ascending) and may lead to abscess of the liver. Patient develops a triad of symptoms which include, pain, fever and jaundice. This triad is termed as Charcot’s triad.
Complication can also occur if a gallstone is blocking the small intestine and it is termed as
Gallstone Ileus: It occurs when a gangrene of the gallbladder leads to the formation of a fistula (channel) between the gallbladder and the duodenum. If a large gallstone passes through the fistula and blocks the duodenum it causes acute intestinal obstruction. Patient develops fever, severe abdominal pain, vomiting, abdominal distension and constipation.
All of the complications mentioned above are serious and life threatening, hence as soon as the patient develops any of the symptoms advice should be sought and immediate treatment should be given.
Acute Cholecystitis: It is an acute inflammation of the gallbladder. In some people the gallstones together with bile might end up irritating the inner wall of the gallbladder itself. This irritation, inflames the gallbladder and the person may develop pain in the upper abdomen, which goes to the back and tip of the right shoulder, with the pain lasting for hours to days. Patients also have nausea and vomiting, fever, tachycardia (rapid heartbeat) and tenderness in the abdomen. If left untreated it might lead to further complications like empyema (pus) of the gallbladder, a perforation or tear in the gallbladder and very rarely gangrene of the gallbladder.
Chronic Cholecystitis: Continuous irritation of the gallbladder over time leads to chronic inflammation, in this condition there is scarring and shrinkage of the gallbladder.
Carcinoma of Gallbladder: Cancer of the gallbladder is very rare, but it has been found that 80% of the patients with cancer had gallstones present in them. It is detected quite late and along with pain the patient exhibits weight loss, anaemia, vomiting and lump in the abdomen.
Complications arising from gallstones present in the common bile duct are:
Obstructive Jaundice: It develops when a biliary stone is blocking the duct. Bilirubin is excreted from the body through faeces or stools. If there is an obstruction the bilirubin stays inside the body and its level increases in the circulating blood. Increased levels of bilirubin can cause:
- Jaundice (yellow discoloration of the skin and eyes due to bilirubin)
- Pale, foul smelling and fatty stools which occur because bile is not being secreted in duodenum and fats are not being absorbed (normal brown colour of the faeces is due to the pigment urobilin which is a product of conjugated bilirubin)
- Dark brown urine (bile pigment is being excreted through urine instead of faeces)
- Itching is caused by deposition of bile acids under the skin.
Acute Pancreatitis: Stones lying near the ampulla of Vater may interfere with the drainage of pancreatic enzymes into the duodenum and along with bile reflux it might lead to inflammation of the pancreas. Patients develop fever, very severe pain around the umbilicus which goes directly to the back, vomiting, tenderness of the abdomen and jaundice.
Ascending Cholangitis: Obstruction of the bile duct leads to high risk of developing bacterial infection. If untreated, the infection spreads from the ducts to the gallbladder and to the liver (hence the term ascending) and may lead to abscess of the liver. Patient develops a triad of symptoms which include, pain, fever and jaundice. This triad is termed as Charcot’s triad.
Complication can also occur if a gallstone is blocking the small intestine and it is termed as
Gallstone Ileus: It occurs when a gangrene of the gallbladder leads to the formation of a fistula (channel) between the gallbladder and the duodenum. If a large gallstone passes through the fistula and blocks the duodenum it causes acute intestinal obstruction. Patient develops fever, severe abdominal pain, vomiting, abdominal distension and constipation.
All of the complications mentioned above are serious and life threatening, hence as soon as the patient develops any of the symptoms advice should be sought and immediate treatment should be given.