Liver and gallbladder stones
1, gallbladder stones: generally do not produce colic, larger stones are not easy to cause obstruction, and can be long-term no obvious symptoms, sometimes occasionally after meals feel distended or vague pain in the upper abdomen, and mostly related to eating greasy food. Smaller stones can often move and become lodged in the neck of the gallbladder, resulting in severe biliary colic with nausea and vomiting; if the position of the lodged stone changes and the obstruction is released, the biliary colic can be relieved. The biliary colic can be relieved. In the early stage of the disease, there is no infection, so there is no chills and fever. When infection and obstruction are associated, the gallbladder may become septic, gangrenous, or even perforated. Acute attacks mostly occur after a full meal or eating fatty food. When lying down, gallbladder stones can easily slide into the cystic duct and cause obstruction, so some patients can have attacks at night. If the patient changes at this time (such as sitting up or sleeping on the side), the stone loosens, slips and returns to the gallbladder, the obstruction is lifted and the pain will be relieved or disappeared.
2,Common bile duct stones: stones can come from the gallbladder or intrahepatic bile duct, or they can originate in the common bile duct. Smaller gallbladder stones can fall into the common bile duct through the cystic duct, forming secondary choledocholithiasis, causing obstructive jaundice and cholangitis. The depth of jaundice varies with the degree of stone impaction and fluctuates. If the gallstone obstructs the bile duct and is infected, the triad of abdominal pain, high fever and jaundice may occur at the same time.
3,Intrahepatic bile duct stones: In recent years, the number of patients with intrahepatic bile duct stones is decreasing. According to our clinical statistics, these stones are mostly yellowish brown, lumpy or mud-like bile pigment stones, and the chemical composition of the stones is mainly calcium bilirubin. Bacterial infection, biliary ascariasis and bile duct obstruction are closely related to the occurrence of intrahepatic bile duct stones, which may also be caused by post-surgical bile duct stricture or poor bile drainage. The clinical manifestations may vary depending on the site of the lesion. When stones descend into the extrahepatic bile duct causing biliary obstruction or acute inflammation, septic cholangitis manifestations such as epigastric colic, chills, high fever and jaundice may occur. If the stone is not dislodged into the extrahepatic bile duct, sometimes it may be complicated by infection, and septic symptoms such as chills and high fever may occur, and in severe cases, toxic shock may occur. Sometimes, intrahepatic bile duct stones block the intrahepatic bile duct for a long time, resulting in liver lesions, such as liver tissue necrosis, abscess formation, and finally part of the liver atrophy and loss of normal function.
Usually there are several parts of performance specifically ureteral stones, kidney stones, renal pelvis stones, calcium stones, bladder stones, etc.
Primary urethral stones often grow gradually or are located within the diverticulum and may be painless in the early stages. Secondary stones are mostly suddenly embedded in the urethra, often with sudden urethral pain and painful urination. The pain may be radiated to the head, the head or the rectum.
Stones cause incomplete obstruction of the urethra, which may result in thinning of the urinary line, bifurcation and weakness of ejaculation, accompanied by frequent urination, urinary urgency and urinary dripping. In secondary urethral stones, due to the sudden embedding of the stone in the urethra, there is a sudden interruption of urination with strong urge to urinate and bladder urgency, and acute urinary retention mostly occurs. In emergency patients, there is often terminal hematuria or hematuria at the beginning of urination, or a little blood dripping out at the end of urination. In chronic patients, mucus or purulent secretions are often present in the urethra, and the majority of patients have localized hard nodules with pressure pain. Multiple stones in the urethral diverticulum can be palpated with a sandstone-like frictional sensation.
They are found on physical examination with ultrasound, negative urinalysis or a few red or white blood cells. Larger stones in the renal pelvis, such as cast stones, may have hematuria after strenuous exercise. For smaller stones, there is microscopic or naked eye hematuria and significant percussion pain in the kidney area. During painful episodes, the patient is pale, has cold sweats, a rapid and weak pulse and even a drop in blood pressure, and is often accompanied by gastrointestinal symptoms such as nausea, vomiting and abdominal distention. During episodes of pain and hematuria, sand grains or small stones may be excreted in the urine. When the stone passes through the urethra, the urine flow is blocked and the patient feels tingling in the urethra.
There may be no specific symptoms. Pain can be caused by the irritation of the bladder mucosa by the stone. It manifests as a dull pain in the lower abdomen and will, or it can be a significant or severe pain. The pain is aggravated by activity and can be relieved by change. It is often accompanied by symptoms of urinary frequency, urgency and pain, and the pain increases at the end of urination. When the stone is embedded in the bladder neck, there may be obvious difficulty in urination, with typical interruption of urination, and it may also cause acute urinary retention.