CLINICAL MANIFESTATION OF PATIENTS WITH GALLSTONES
Dr. Anam Ghaffar*, Dr. Muhammad Baber Shehzad, Dr. Saad Sharif
ABSTRACT
Background: Gallstone is a major health problem worldwide. Cholelithiasis prevalence in Pakistan is about 15 to 20 %. Old age, female, obesity, fatty food and diabetes mellitus are the common risk factors for gallstone formation. Objective: To evaluate the clinical profile of patients with cholelithiasis. Methodology: It is a cross-sectional study done at Mayo Hospital Lahore from August 2017 to October 2017. We enrolled 75 patients in the study of age more than 20 years of age diagnosed as cholelithiasis to study their clinical profile. All diagnosed patients of gallstones through ultrasound were admitted in the ward. Clinical presentation like signs, symptoms and preoperative ultrasound findings of all patients were noted on a proforma. Results: A Total 75 were patients with history of admitted Cholelithiasis were enrolled in the study after taking informed consent. The mean age of patient was 45.5±6.48 years in a range from 21 to 70 years. Female preponderance was found with 54 (72%) patients and male to female ratio was 1:2.5. Majority of the patients (32%) were in age group 41-50 years. The clinical features observed in patients were fever in 24 (32%), nausea and vomiting in 34 (45%), jaundice in 9 (18%) and dyspepsia in20 (26%). Abdominal pain (right hypochondrium or epigastric region) was the most common complaint i.e. 69 (92%). The ultrasound findings among patients were single stone 23 (30.6), multiple stones 52 (69.3%), stone impacted in bile duct 9 (12%), thickening of gallbladder 17(22.66%), Empyema 5 (6.6%) and Mucocele 10 (13.3%). Forty-nine (65.3%) of patients managed by laparoscopic cholecystectomy and 15 (20%) by open cholecystectomy, due to intra-operative complications 6 (8%) laparoscopic surgeries were converted to open cholecystectomy. Out of 75 patients, 5 were managed conservatively. Mixed type gallstones were most common (57%) on biochemistry. Conclusion: We concluded that the incidence of gallstones is very high after forty year of age with female preponderance. The most common presenting complaint was pain and tenderness at right hypochondrium. Ultrasound proved to be best screening test for cholelithiasis.
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