Gallstones : Complications

Comments:
Gallstones - Complications: Gallstones may obstruct cystic duct or common bile duct causing obstructive jaundice, biliary-type pain, and create a risk of acute cholecystitis, ascending cholangitis or acute biliary pancreatitis. Acute cholecystitis can lead to empyema and perforation. Stone impacted in the gallbladder neck or the cystic duct can externally compress the common hepatic duct, resulting in jaundice, bile duct obstruction, and sometimes a fistula (Mirizzi Syndrome; <0.1%).

Gallstones may erode through mucosa and create cholecystoenteric fistulas between gallbladder and duodenum or colon (<0.1%). Smaller stones pass into the gut and get excreted without producing downstream sequelae. Larger stones may produce small intestinal obstruction resulting in gallstone ileus, and colonic or appendiceal obstruction. Stone eroding through gallbladder into the duodenum through a fistula can cause gastric outlet obstruction (Bouveret's syndrome).

Gallbladder carcinoma is a rare complication of long-standing cholelithiasis (<0.1%).

The image shows a resected segment of ileum with a large gallstone. The patient presented with intestinal obstruction.