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Epidemiology: The prevalence of gallstones increases with age and there is a strong female predilection. A genetic predisposition is present in certain groups.

The highest prevalence of gallstones (mainly cholesterol type) is seen in native populations of North and South America (60-80%). The prevalence in various groups in the US is as follows: non-hispanic females 16.6%; non-hispanic males 8.6%; and Native Americans of Pima, Hopi and Navajo groups 70% of females after the age of 25 years. The prevalence in non-hispanic Whites, Asians, and Blacks is much lower. Gallstones are quite common in Chile and some Scandinavian countries and infrequent in Asia and Africa.

Interactions between genetic and environmental factors play a key role in lithogenesis. The role of several important risk factors and lithogenic genes is discussed in the next few images.

The image shows multiple cholesterol gallstones in an acutely inflamed gallbladder.

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