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Delayed treatment of gallstone disease has many dangerous complications

Dr. Do Tuan Anh, Head of Hepatobiliary Surgery Department (Viet Duc Hospital), said that gallstone disease is a gastrointestinal disease caused by the formation of stones in the gallbladder.

This is a common disease, affecting about 20% of the world’s population. In Vietnam, gallstones are mainly found in the main biliary tract, of which gallstones in the liver account for 20-56%. About 20% of the population will develop gallstones in their lifetime, of which 20-30% develop symptoms of the disease.

“In the past time, we have received many patients with gallstones with many dangerous complications such as acute pancreatitis, acute biliary obstruction due to delay in going to the doctor. Meanwhile, gallstone disease is very simple to detect. through ultrasound and do some paraclinical tests.

Delayed treatment of gallstone disease has many dangerous complications - Photo 1.

Dr. Do Tuan Anh, Head of Hepatobiliary Surgery Department (Viet Duc Hospital) is examining a patient suspected of having gallstones. Photo of BVCC

Therefore, if people feel abdominal pain, especially liver pain, fever, signs of jaundice, etc., they need to go to a medical facility for examination. If people are subjective, leaving the disease in a serious condition will lead to many complications such as cholecystitis or stones falling into the biliary tract, causing complications of acute pancreatitis, acute biliary obstruction, “said Dr. Tuan Anh.

“In Vietnam, the rate of people suffering from gallstones is very high, 90% of diseases of gallstones in and out of the liver are related to pancreatic and liver diseases.

The proportion of people in rural areas with biliary stone disease is still high due to parasitic infection. Meanwhile, at present, there is an increasing trend of gallstone diseases in people living in urban areas, like some developed countries.”

Dr. Do Tuan Anh

According to Dr. Tuan Anh, if gallstone disease is detected early, the treatment is quite simple and does not affect the patient’s health much. However, if detected late, it often causes many dangerous complications.

5 dangerous complications of gallstone disease

– Peritoneal cholecystitis and biliary peritonitisBiliary obstruction and infection caused by stones lead to increased pressure in the biliary tract, damaging the biliary system, through which infectious bile can penetrate the peritoneal cavity, causing abdominal infection. In severe cases, biliary necrosis can cause biliary peritonitis.

Acute pancreatitis due to stones: A very common complication, including acute pancreatitis with edema and necrosis. Necrotizing pancreatitis can easily lead to septic shock and even death. The patient has severe pain, vomiting and epigastric spasticity accompanied by symptoms of cardiovascular collapse in severe cases.

Bleeding of the biliary tract: The patient has symptoms of gallstones and is vomiting blood and black stools, typically vomiting blood clots in the shape of a pencil. Gastroscopy revealed blood in the duodenum of biliary origin.

Purulent cholangitis and hepatobiliary abscess: In tropical countries, cholangitis is common among biliary tract diseases. In cholangitis, the cause is the leading stone (from 77.78 to 97.52%). The patient has a lot of pain in the liver area, severe infection: high fever, chills, dry lips, dirty tongue, exhausted body due to lack of water and poisoning.

Shock infection of the biliary tract: It is a serious complication, accounting for 16-24%. Mostly seen in the elderly, 75% in people over 50 years old. Central biliary tract shock is the leading cause of death for patients, often seen in patients with gallstones, severe pain and fever but not promptly treated.

Signs of gallstone disease

According to TS.BS Do Tuan Anh, in each person, the manifestations of gallstones are not the same, but some typical symptoms of gallstones must include:

Right lower quadrant pain: The pain usually occurs in the right lower quadrant or epigastrium spreading to the right shoulder and to the back. The pain is usually dull or intense depending on where the stone occurs.

Fever, chills: People with gallstones may have a fever or a cold due to a biliary tract infection or cholecystitis. Patients often have a high fever of over 38 degrees Celsius with a feeling of chills, sweating a lot after the fever subsides.

Digestive disorders: Some gallstone patients experience symptoms of fear of fatty foods, heartburn, bloating, indigestion… These symptoms are easily mistaken for some diseases related to the digestive tract, stomach pain, so many people apply it. inappropriate treatment.

Jaundice: Depending on the progression of gallstones, the degree of jaundice varies from patient to patient. This symptom is often accompanied by severe itching. However, when there are persistent pain symptoms in the right flank: dull or severe pain spreading to the back or epigastrium; high fever, yellow skin, yellow urine… is also the time when gallstone disease causes serious complications.

In addition, Dr. BS Do Tuan Anh also said that people with gallstones may experience chronic complications of hepatobiliary disease such as:

– Biliary cirrhosis: A disease in which the bile ducts in the liver are gradually destroyed, destruction of the bile ducts can cause toxic substances to accumulate in the liver and sometimes lead to scarring of liver tissue (cirrhosis). Many experts believe that biliary cirrhosis is an autoimmune disease in which the cells fight against their own. Biliary cirrhosis develops slowly, and early treatment of the cause can slow the progression of the disease. Biliary cirrhosis causes cirrhosis complications, portal hypertension, intrahepatic cholangiocarcinoma.

– Cancer of the biliary tract: Caused by repeated, prolonged cholangitis; Common clinical symptoms are weight loss, jaundice may be seen if the tumor is compressing the biliary tree.

Some cases with gallstones, stones in the liver have no obvious symptoms, but when there are symptoms of prolonged pain in the right flank such as dull pain or severe pain spreading to the back or epigastrium; high fever, yellow skin, yellow urine… is also the time when gallstone disease causes serious complications. According to statistics, only about 10-20% of patients have gallstone disease from the time of diagnosis to the time of symptoms, after 5-20 years. As for the symptoms of the disease, that is, when there are complications, then going to the hospital is quite common among people with gallstone disease, Dr. Do Tuan Anh added.

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