Q. Kindly explain the management of gallstone.

Answered by
Dr. Ajeet Kumar Lohana
and medically reviewed by Dr. Divya Banu M
This is a premium question & answer published on May 30, 2020 and last reviewed on: Jun 11, 2020

Hi doctor,

I have a single gallstone. I am not facing any symptoms but about last week I felt a severe and intense pain in stomach and immediately to back which continues until I had an Decloyran injection. This pain did not spread over the abdomen. When we met the doctor he checked very carefully and said that it was not the pain of gall stone.

The doctor asked for an ultrasound and in ultrasound the stone was in its place. No inflammation or fluid accumulation. Gall bladder size was normal. The doctor said that the pain was due to twist of certain veins and is not due to gallstone. I want to ask that whether twisting of vein can cause pain? Is it necessary to do operation? Is there any way to remove single gallstone?

Dr. Ajeet Kumar Lohana

Medical Gastroenterology
#

Hello,

Welcome to icliniq.com.

So starting from answering your first question. The pain of twisting of veins is an strange term in itself. Why would veins twist around in a healthy young lady with no previous significant medical history. So I do not believe this.

Second, the gall bladder is not removed in asymptomatic gall stones. Asymptomatic gall stones are those which do not cause symptoms, and the symptoms of gall stones occur usually when the stone size is 10 mm, if smaller than this, it is unlikely that your pain was gall stone related. Since you did not mention size of gall stones, otherwise it would have been easy to tell you whether it was cause of your pain or not.

Other, the pain of gall stones has to be typical in nature; the pain which occur in right upper quadrant of the abdomen (at site of your liver), pain starts suddenly mostly after half hour of meals, peaks within 1 hours, and then starts settling in next 4 to 6 hours. Vomiting and nausea can frequently accompany with this pain. If you have that typical type of pain, then it may be from gall bladder.

Your third question. The answer is no. No drug therapy can prevent from formation of stones or dissolution of stone. There are some therapies which are used as in experience, but they are not recommended at all. If gall bladders stones are symptomatic then they has to be removed by doing gall bladder resection via laparoscopy. If not symptomatic, then no need of any drug or surgical therapy.

Having said that, elective gall bladder resection is indicated among patients who could not bear the risk of cholecystitis, such as pregnant ladies with size of stones more than 10 mm, or patients with smaller gallbladder stones but having pancreatitis. Stone but without symptoms and presence of gall bladder polyps. These three types of patients can have surgery despite no symptoms.


The Probable causes:

Gall bladder stones

Probable diagnosis:

Gall bladder stones

Regarding follow up:

Follow up to discuss plan of action in your case from now onwards. Ruling out other causes of your abdominal pain, on history and some preliminary investigations.


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