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Gallstones are more common in pregnant women due to elevated hormones and cholesterol levels, which block the bile duct and obstruct bilirubin excretion. [11] Besides, preeclampsia and eclampsia , denoted by high blood pressure , are linked to hyperbilirubinemia through damaging highly perfused organs , particularly liver and kidneys . [ 12 ]
In the developed world, 10 to 15% of adults have gallstones. [3] Of those with gallstones, biliary colic occurs in 1 to 4% each year. [3] Nearly 30% of people have further problems related to gallstones in the year following an attack. [3] About 15% of people with biliary colic eventually develop inflammation of the gallbladder if not treated. [3]
Cholestatic pruritus is the sensation of itch due to nearly any liver disease, but the most commonly associated entities are primary biliary cholangitis, primary sclerosing cholangitis, obstructive choledocholithiasis, carcinoma of the bile duct, cholestasis (also see drug-induced pruritus), and chronic hepatitis C viral infection and other forms of viral hepatitis.
C-reactive protein is usually elevated although not commonly measured in the United States. [1] Bilirubin levels are often mildly elevated (1–4 mg/dL). [14] If bilirubin levels are more significantly elevated, alternate or additional diagnoses should be considered such as gallstone blocking the common bile duct (common bile duct stone). [1]
Common bile duct stone, also known as choledocholithiasis, is the presence of gallstones in the common bile duct (CBD) (thus choledocho-+ lithiasis). This condition can cause jaundice and liver cell damage. Treatments include choledocholithotomy and endoscopic retrograde cholangiopancreatography (ERCP).
The bile components that form gallstones include cholesterol, bile salts, and bilirubin. [2] Gallstones formed mainly from cholesterol are termed cholesterol stones, and those formed mainly from bilirubin are termed pigment stones. [2] [3] Gallstones may be suspected based on symptoms. [4] Diagnosis is then typically confirmed by ultrasound. [2]
Gallstones form when the bile is saturated, usually with either cholesterol or bilirubin. [20] Most gallstones do not cause symptoms, with stones either remaining in the gallbladder or passed along the biliary system. [21] When symptoms occur, severe "colicky" pain in the upper right quadrant of the abdomen is often felt. [20]
Cholestasis is a condition where the flow of bile from the liver to the duodenum is impaired. [1] The two basic distinctions are: [1] obstructive type of cholestasis, where there is a mechanical blockage in the duct system that can occur from a gallstone or malignancy, and