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Gallstones are formed in the gallbladder due to  hardened deposits of normal liver bile fluid secretions either due to defective Gall bladder function or other conditions

While many people with gallstones may not experience symptoms, in some cases, these stones lead to severe pain and life-threatening complications. Understanding the symptoms, diagnostic methods, and urgency of surgical intervention can help manage gallstone emergencies effectively.

What Are Gallstones?

Gallstones are formed when substances in bile—such as cholesterol, bilirubin, and bile salts—crystallize and harden. They can vary in size, from tiny grains to larger stones. They may develop due to factors such as obesity, rapid weight loss, pregnancy, diabetes,  sickle cell disease, defective Gall bladder function, or a high-cholesterol diet.

Symptoms of a Gallstone Emergency

Gallstones may remain asymptomatic for years, but when they obstruct the gallbladder bladder passage or bile ducts, they can trigger intense symptoms that require immediate medical attention.

1. Severe Abdominal Pain (Biliary Colic)

• Sudden, sharp pain in the upper right abdomen or just below the rib cage.
• Pain may radiate to the right shoulder or back.
• Often occurs after fatty meals and can last for several hours.

2. Jaundice

• Yellowing of the skin and eyes due to bile flow blockage in the biliary tract.
• Indicates obstruction of the bile duct, possibly leading to cholangitis, severe pruritus and liver damage.

3. Nausea and Vomiting

• Persistent nausea, sometimes accompanied by vomiting, especially after eating.
• May be a sign of gallstone-induced inflammation or infection.

4. Fever and Chills

• High fever with chills may indicate an infection such as acute cholecystitis (inflammation of the gallbladder) or cholangitis (blood infection due to blockage of the bile duct).
• Requires immediate medical intervention to prevent sepsis.

5. Dark yellow Urine and Pale Stools

• Dark-coloured urine suggests excess bilirubin in the bloodstream.
• Clay-coloured stools result from blocked bile flow, affecting digestion.

6. Rapid Heart Rate and Low Blood Pressure

In severe cases, gallstone complications can lead to shock, especially if infection spreads to the bloodstream (septicemia).

Diagnosis of Gallstone Emergencies

If gallstone complications are suspected, a series of tests are conducted to confirm the diagnosis and assess the severity of the condition.

1. Ultrasound

• The most common and non-invasive imaging test to detect gallstones.
• Helps determine the presence of stones and signs of inflammation.

2. Blood Tests

• Elevated white blood cell count suggests infection or inflammation.
• Liver function tests check for bile duct obstruction.

3. CT Scan or MRI (MRCP – Magnetic Resonance Cholangiopancreatography)

Used to detect stones in bile ducts and assess complications.

MRCP

4. Endoscopic Retrograde Cholangiopancreatography (ERCP)

A procedure that combines endoscopy and X-ray to detect and remove stones in bile ducts.

Can also place a stent to relieve blockages.

The Need for Surgery in Gallstone Emergencies

When gallstones cause severe pain, infection, or complications, surgery is often the best treatment option.

1. Laparoscopic Cholecystectomy (Gallbladder Removal Surgery)

The most common and preferred treatment for recurrent gallstone attacks.

A minimally invasive procedure with small incisions, less pain, and quicker recovery.

2. Open Cholecystectomy

Performed in complicated cases where laparoscopic surgery is not suitable.

Requires a larger incision and a longer recovery period.

3. ERCP for Stone Removal

If stones are blocking the bile duct, ERCP can remove them without gallbladder removal.

Often used for patients who are not candidates for surgery.

Post Lap Chole ERCP stone clearance of CBD

When to Seek Emergency Medical Care?

• If you experience any of the following symptoms, seek immediate medical attention:
• Intense and persistent abdominal pain.
• High fever, chills, or jaundice.
• Signs of sepsis, such as confusion, rapid heartbeat, or low blood pressure.

Key Notes for Readers

Gallstone emergencies can lead to serious complications if not treated promptly. Recognizing symptoms early and seeking timely medical care can prevent life-threatening conditions. In most cases, surgical removal of the gallbladder is the most effective long-term solution to prevent future attacks and complications.