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In medicine, gallstones (choleliths) are crystalline bodies formed within the body by accretion or concretion of normal or abnormal bilecomponents.

Gallstones can occur anywhere within the biliary tree, including the gallbladder and the common bile duct. Obstruction of the common bile ductis choledocholithiasis; obstruction of the biliary tree can cause jaundice; obstruction of the outlet of the pancreatic exocrine system can cause pancreatitis. Cholelithiasis is the presence of stones in the gallbladder or bile ducts: chole- means “bile”, lithia means “stone“, and -sis means “process”.



A gallstone’s size varies and may be as small as a sand grain or as large as a golf ball. The gallbladder may develop a single, often large stone or many smaller ones. They may occur in any part of the biliary system.


Gallstones have different appearance, depending on their contents. On the basis of their contents, gallstones can be subdivided into the two following types:



  • Cholesterol stones are usually green, but are sometimes white or yellow in color. They are made primarily of cholesterol, the proportion required for classification as a cholesterol stone being either 70% (Japanese classification system) or 80% (US system) [1]
  • Pigment stones are small, dark stones made of bilirubin and calcium salts that are found in bile. They contain less than 20% of cholesterol. Risk factors for pigment stones include hemolytic anemiacirrhosisbiliary tract infections, and hereditary blood cell disorders, such as sickle cell anemia and spherocytosis.

The proportions of these different types of stone found varies between samples, and is thought to be affected by the age and ethnic or regional origin of the patients [2]

Mixed stones

All stones are of mixed content to some extent. Those classified as mixed, however, contain between 30% and 70% of cholesterol. In most cases the other majority constituent is calcium salts such as calcium carbonate, palmitate phosphate, and/or bilirubinate. Because of their calcium content, they can often be visualized radiographically.




Researchers believe that gallstones may be caused by a combination of factors, including inherited body chemistry, body weight, gallbladder motility (movement), and perhaps diet.

Pigment gallstones

  • Conditions causing hemolytic anemia can cause pigment gallstones.[4] Hemolytic anemia is anemia due to hemolysis, the abnormal breakdown of red blood cells (RBCs) either in the blood vessels (intravascular hemolysis) or elsewhere in the body (extravascular). It has numerous possible causes, ranging from relatively harmless to life-threatening. The general classification of hemolytic anemia is either acquired or inherited. Treatment depends on the cause and nature of the breakdown.



  1. ^ . Kim, I. S., Myung, S. J., Lee, S. S., Lee, S. K., Kim, M. H. (2003). Classification and nomenclature of gallstones revisited. Yonsei Medical Journal, 44, 561-570.
  2. ^ Channa, N. A., Khand, F. D., Khand, T. U., Leghari, M. H., Memon, A. N. (2007). Analysis of human gallstones by Fourier transform infrared. Pakistan Journal of Medical Science, 23, 546-550.
  3. ^ Erythropoietic Protoporphyria at Merck Manual of Diagnosis and Therapy Home Edition
  4. ^
  5. ^ Ortega RM, Fernández-Azuela M, Encinas-Sotillos A, Andrés P, López-Sobaler AM (1997). “Differences in diet and food habits between patients with gallstones and controls”. J Am Coll Nutr 16 (1): 88–95. PMID 9013440.
  6. ^ Misciagna G, Leoci C, Guerra V, et al. (1996). “Epidemiology of cholelithiasis in southern Italy. Part II: Risk factors”. Eur J Gastroenterol Hepatol 8 (6): 585–93. doi:10.1097/00042737-199606000-00017PMID 8823575.

January 27, 2010 - Posted by | Blood, Cells, Gallbladder, Liver, Pancreas

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