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V. PATHOPHYSIOLOGY PREDISPOSING FACTORS Non-Modifiable • • • •
Modifiable • •
Family History Race (Native American, Caucasian, Mexican-American) Age (Forty) Gender (Female) • • • • • •
DM / Hemolytic disease / liver disorders Obesity / high-caloric diet / high cholesterol diet (hyperalimentation) • Pregnancy / multiparity • Eliminated estrogen (Fertile) Abnormal bile constituent secretions Familial Biliary stasis Decrease gallbladder emptying Decrease bile solubility Decrease absorptive ability of gallbladder Increase bile concentration Precipitation Decrease concentration of bile salts Liver secretes bile high in cholesterol
}
Formation of stone in the gallbladder
Bile may obstruct & remain in the gallbladder
Bile initiates chemical A reaction
Heavy fat meal
Secretion of
B cholecystokinia
Antolysis & edema
A
Blood Vessels Compressed Pain (Guarding Behavior) Gangrene Increase SGPT Increase Decrease Ischemia intestinal ofAlkaline tissue Phosphatase Perforation Pain (Guarding possible Behavior) Steatorrhea Possible of stone absorption surrounding of fatty the Weight Loss Cachexia acids
B Gallstone may move and dislodge Stone in the ductal Decrease Fever fat soluble System 18 vitamin Chills absorption Vomiting Backflow Jaundice of bile Bleeding Inflammation Could tendencies lead to Irritation Lukocytosis Serum Fat Bilirubin intolerance Increase PTT Weakness Clay-colored stool infection
Gallbladder contracts and tries to empty
Modifiable • •
Family History Race (Native American, Caucasian, Mexican-American) Age (Forty) Gender (Female) • • • • • •
DM / Hemolytic disease / liver disorders Obesity / high-caloric diet / high cholesterol diet (hyperalimentation) • Pregnancy / multiparity • Eliminated estrogen (Fertile) Abnormal bile constituent secretions Familial Biliary stasis Decrease gallbladder emptying Decrease bile solubility Decrease absorptive ability of gallbladder Increase bile concentration Precipitation Decrease concentration of bile salts Liver secretes bile high in cholesterol
}
Formation of stone in the gallbladder
Bile may obstruct & remain in the gallbladder
Bile initiates chemical A reaction
Heavy fat meal
Secretion of
B cholecystokinia
Antolysis & edema
A
Blood Vessels Compressed Pain (Guarding Behavior) Gangrene Increase SGPT Increase Decrease Ischemia intestinal ofAlkaline tissue Phosphatase Perforation Pain (Guarding possible Behavior) Steatorrhea Possible of stone absorption surrounding of fatty the Weight Loss Cachexia acids
B Gallstone may move and dislodge Stone in the ductal Decrease Fever fat soluble System 18 vitamin Chills absorption Vomiting Backflow Jaundice of bile Bleeding Inflammation Could tendencies lead to Irritation Lukocytosis Serum Fat Bilirubin intolerance Increase PTT Weakness Clay-colored stool infection
Gallbladder contracts and tries to empty
