Gallstones top to toe: what the radiologist needs to know

Abstract

Gallstone-related disease can have significant associated morbidity and mortality worldwide. The incidence of gallstone-related disease in the Western world is on the increase. There are multiple different pathological manifestations of gallstone disease: the presentation, diagnosis and associated complications of which vary significantly depending on anatomical location. The role of imaging in gallstone-related disease is broad with radiology playing an essential role in the diagnosis, management and follow-up of gallstonerelated pathologies. This paper distills the broad range of gallstone-related pathologies into an anatomical map, discussing the disease processes involved at each point along the biliary tree and reviewing the strengths and weaknesses of different imaging modalities for each distinct disease process.

Increased incidence of acute calculous cholecystitis observed during COVID-19 social restrictions

“…Gallstones are solid rounded particles composed of a combination of cholesterol and bilirubin that form within the gallbladder and biliary system [2]. The primary risk factor for the development of gallstones is a high fat diet [3,4].…”

The Relationship between Choledocholithiasis and Liver Enzymes in Elderly Patients

“…The present study showed that the results of performed tests were not related to the formation of gallstones. Despite the previous belief that there is a limited useful prediction for these tests for the formation of stones (Murphy et al, 2020). Kaldor et al reported that patients with cholecystitis who undergo laparoscopy for cholecystectomy have limited predictability of liver enzymes.…”

Risk of Gallstone Formation in Aberrant Extrahepatic Biliary Tract Anatomy: A Review of Literature

“…Three types of gallstones exist in practice: cholesterol, pigment, and mixed stones. Cholesterol stones account for 10% of all gallstones and result when cholesterol concentration exceeds the solubilizing capacity of bile which leads to the precipitation of cholesterol crystals [ 3 ]. They are pale yellow, formed only in the gallbladder and have a cholesterol content ranging from 50% to 100% [ 39 ].…”

“…Meanwhile, In Europe, ultrasound studies suggest a prevalence of 9%-21% [ 2 ]. The rising incidence of gallstone disease in western countries is considered to be a consequence of increasing obesity rates [ 3 ]. The age-long mnemonic of '5Fs' (fat, female, fertile, fair, and forty) has traditionally been used in medical school instructions to describe the risk factors for gallstone disease.…”