Black Pigment Gallstone : Pathophysiology

Black Pigment Gallstones - Pathophysiology: In normal physiologic conditions, unconjugated bilirubin is a minor component of bile (< 1% of total bile pigments). In patients with pigment gallstones, there is an excess of unconjugated bilirubin in the bile. This is analogous to the supersaturation of bile with cholesterol in patients with cholesterol gallstones. Any condition that increases the levels of unconjugated bilirubin elevates the risk of pigment stones. (continued in the next image)

The image shows a black pigment stone with shiny surface and irregular contours. Image courtesy of: Dr. Pascual Meseguer (@Histopatolomon), Spain; used with permission