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Gallstones can become life threatening: Prof. Faisal Ghani.

HYDERABAD -- Gallstones can present in a number of ways. These can be found incidentally on ultrasound done for some other reason while or they can result into a life threatening episode of inflammation of pancreas.

Often this surgery can be done through small incisions in the abdomen (laparoscopic Cholecystectomy), but sometimes it requires a more extensive operation, informed eminent surgeon and Associate Professor of Surgery Liaquat University of Medical and Health Sciences Jamshoro Dr.Faisal Ghani Siddiqui while talking to reporter here on Tuesday.

He informed that Cholecystitis is inflammation of the gallbladder, a small organ near the liver that plays a part in digesting food.

Highlighting his research work, he said gallstone disease is common among women of low-income families in southern areas of Sindh.

Dr.Faisal Ghani Siddiqui said oil, continuous use of green vegetables (saag, palak and tomato) and smoking are main causes of gallstone disease in the age group of 40 to 45.

The scholar said overall objectives of the present study were to find out surgical incidence and epidemiological risk factors for the disease.

Dr.Faisal Ghani Siddiqui said gallstone is a concretion that forms in the gallbladder and added that there are three types of gallstone, cholesterol, pigment and mixed composition stone, and the pathogenesis of these involve four steps, including super saturation, gallbladder hypo-motility, nucleation and aggregation, he added.

He said in Hyderabad and its adjoining areas, gallstone disease are fairly common. Here cholesterol gallstones are far more prevalent than the pigment and mixed composition stones and the incidence of cholesterol gallstone is significantly high in males, whereas reverse is true for pure pigment stones.

However, he further said, no systematic study has been carried out so far in this area in order to find true surgical incidence of gallstone disease and its association with various epidemiological and biochemical risk factors.

Dr. Faisal Ghani informed about the causes Cholecystitis a gallstone stuck in the cystic duct, a tube that carries bile from the gallbladder, is most often the cause of sudden (acute) cholecystitis. The gallstone blocks fluid from passing out of the gallbladder, he said and added that this results in an irritated and swollen gallbladder. Infection or trauma, such as an injury from a car accident, can also cause Cholecystitis, he added.

He said that Acute Acalculous Cholecystitis, though rare, is most often seen in critically ill people in hospital intensive care units. In these cases, there are no gallstones, he said and added that complications from another severe illness, such as HIV or diabetes, cause the swelling.

About the symptoms, Dr Faisal Ghani informed that the most common symptom of Cholecystitis is pain in patient upper right abdomen that can sometimes move around to patients back or right shoulder blade. Other symptoms include nausea or vomiting, fever and pain that gets worse during a deep breath, he said and added that pain for more than 6 hours, particularly after meals. Older people may not have fever or pain. Their only symptom may be a tender area in the abdomen, he added.

Dr. Faisal Ghani said that sometimes acute cholecystitis is caused by one or more gallstones getting stuck in the main tube leading to the intestine, called the common bile duct. Treatment may involve an endoscopic procedure to remove the stones in the common bile duct before the gallbladder is removing, he added.

He said that females between the age group of 30 and 44 years were seen to be more prone to develop gallstones than females of any other age group. 29.45 percent female gallstone patients were having up to 3 children and 70.55 percent had more than three children, he added.

Patient history subsequently confirmed by laboratory findings showed that 53.3 percent of gallstone patients had jaundice and 23.35 percent diabetes mellitus.

Dr.Faisal Ghani Siddiqui said that sometimes acute Cholecystitis is caused by one or more gallstones getting stuck in the main tube leading to the intestine, called the common bile duct. In rare cases of chronic Cholecystitis, he said that patients may also receive medicine that dissolves gallstones over a period of time.

About the treatment, he informed the most common and most effective treatment is surgical removal of the gallbladder with part of liver and lymph node dissection.
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Publication:Balochistan Times (Baluchistan Province, Pakistan)
Date:Apr 11, 2018
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