Page 177 - Color Atlas Of Pathophysiology (S Silbernagl Et Al, Thieme 2000)

C. Causes of Pigment Stone Formation
Bilirubin Bacteria
Hemolytic glucuronide (cholangitis, cholecystitis)
anemia
Non-
enzymatic β-gluco-
sidase
Micellar formation
Liver cirrhosis
Unconjugated bilirubin Free fatty acids pH

Calcium Calcium palmitate Calcium carbonate
Cholelithiasis II
bilirubinate and -stearate and -phosphate
Pigment stones
D. Role of Gall Bladder in Cholelithiasis
Vagotomy Pregnancy CCK deficiency, Bile:
vagotomy, Cholesterol/Bile salt Plate 6.17
Acetyl- pregnancy (cf fig. A),
bile concentration
choline
Mucus Gallbladder emptying
(not often enough, Fasting
incomplete)
Fats Cholesterol
Prosta- crystals
glandins
Bile lingers for
Pancreatic a long time
insufficiency
FFA
CCK Mucus
secretion
Gall stones
E. Consequences of Cholelithiasis

Gall stones

Cholangitis, ob-
Acute structive jaundice,
Spasm cholecystitis pancreatitis

Ulceration,
perforation
Colic Carcinoma
167
(partly after Netter)
Silbernagl/Lang, Color Atlas of Pathophysiology © 2000 Thieme
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