PREDISPOSING/ NON-MODIFIALBE GENDER: FEMALE AGE: 40 MULTIPAROUS

PRECIPITATING/ MODIFIABLE LIFESTYLE FERTILE DISEASE

AGEING ESTROGEN IN WOMEN USE OF ORAL CONTRACEPTIVES

MEDICATION SUCH AS CLOFIBRATE

ILEAL DISEASE INTESTINAL BYPASS SURGERY

PREGNANCY STARVATION RAPID WEIGHT LOSS

FATTY LIVER

SERUM CHOLESTEROL LEVELS BILE ACID SYNTHESIS

BILE COMBINES WITH CHOLESTEROL IN THE LIVER

MALABSORPTION OF BILE SALTS

EXCRETION OF GALL BLADDER SLUDGE

HEPATIC SECRETION OF
SUPER SATURATED CHOLESTEROL

EMULSIFICATION OF CHOLESTEROL

SLUGGISH BILE FLOW

CHEMICAL IRRITATION TO BALLDER

PRECIPITATION OF CHOLESTEROL/PIGMENT CRYSTALS STONE FORMATION IN THE HEPATIC DUCT

CHOLECYSTITIS

INFLAMMATION OF THE GALLBLADDER

CHOLELITHIASIS

CHOLESTEROL/PIGMENT STONE FORMATION IN THE GALL BLADDER

ALTERATION IN THE ABSORPTIVE CHARACTERISTIC OF THE MUCOSAL LAYER

OBSTRUCTION OF GALL STONES AND INFLAMMATION OF THE COMMON BILE DUCT

DISLODGEMENT OF STONE IN THE COMMON BILE DUCT

ABSORPTION
OF WATER AND BILE SALTS SUPER SATURATION OF CHOLESTEROL IN THE BILE ON THE GALL BLADDER CHOLEDOCOLITHIASIS

SIGNS/SYMPTOMS MANIFESTED ON THE PATIENT: BILIARY COLIC JAUNDICE YELLOWISH CONJUNCTIVA TENDERNESS IN THE RIGHT UPPER QUADRANT OF THE ABDOMEN

Extrusion of stones from Gallbladder

Impaction at cystic and bile duct

Distention of biliary tree and fundus of gallbladder

Bile not excreted to doudenum Backflow of bile and goes to the circulation

Forceful contractions of gallbladder

levels of bilirubin/bile pigments in the circulation

Spasm of smooth muscle in the ducts

conversion of bilirubin to urobilinogen in the intestines excretion of urobilinogen in stool

Fat not emulsified No absorption of fat in the intestines Nausea and Vomiting Fullnes Indigestion Vit. ADEK defeciences

PAIN

Renal secretion of bilirubin

Obstructive Jaundice Pruritus

Grayish stool
Dark urine