Cholesterol Gallstones : Pathophysiology

Comments:
Pathophysiology of Gallstones - Role of Bile Stasis: Another important risk factor for both cholesterol and pigment stones is decreased gallbladder motility with incomplete emptying. Bile stasis may be neurogenic, hormonal (e.g. during pregnancy), or inflammation-induced. Stagnation of supersaturated bile creates a lithogenic environment. Without some kind of bile stasis, stones would not be able to grow in size and would be extruded in bile while still in gravel or particulate form.

Unlike pigment stones, the role of parasites/bacteria in the pathogenesis of cholesterol gallstones is not clear. PCR studies have demonstrated the presence of Pseudomonas, E. coli, and Helicobacter in cholesterol stones. Whether these bacteria are causative agents or mere bystanders is not known.

The image shows variably-sized, multifaceted cholesterol stones.