Biochemical Investigations vs Ultrasonography in Diagnosis of Bile Stones

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Biochemical Investigations vs Ultrasonography in Diagnosis of Bile Stones

Journal Title: INTERNATIONAL JOURNAL OF CURRENT RESEARCH IN MEDICAL SCIENCES - Year 2019, Vol 5, Issue 4

Abstract

Gallbladder stones are an extremely common disorder and are usually asymptomatic. Some patients experience biliary colic, an intermittent and often severe pain in the epigastrium or right upper quadrant, and at times between the scapula because of temporary obstruction of the cystic duct with a gallstone. Ultrasonography, complete blood picture test and liver function tests are procedures of choice in suspected gallstones or biliary diseases. They are the most sensitive, specific, non-invasive and inexpensive tests for the detection of gallstones. Our main objective was to evaluate the relationship of ultrasonographic findings, hemolytic indices and liver function tests with gallstones. If the cystic duct obstruction persists, the gallbladder becomes inflamed and the patient develops cholecystitis, an acute inflammation and infection of the gallbladder. Gallbladder stones are an extremely common disorder and are usually asymptomatic. Some patients experience biliary colic, an intermittent and often severe pain in the epigastrium or right upper quadrant, and at times between the scapula because of temporary obstruction of the cystic duct with a gallstone. If the cystic duct obstruction persists, the gallbladder becomes inflamed and the patient develops cholecystitis, an acute inflammation and infection of the gallbladder. A gallstone is a stone formed within the gallbladder out of bile components. [4] The term cholelithiasis may refer to the presence of gallstones or to the diseases caused by gallstones.[5] Most people with gallstones (about 80%) never have symptoms.[13] When a gallstone blocks the bile duct, a cramp-like pain in the right upper part of the abdomen, known as biliary colic (gallbladder attack) can result.[4] This happens in 1–4% of those with gallstones each year.[14] Complications of gallstones may include inflammation of the gallbladder (cholecystitis), inflammation of the pancreas (pancreatitis), jaundice, and infection of a bile duct (cholangitis).[4][6] Symptoms of these complications may include pain of more than five hours duration, fever, yellowish skin, vomiting, dark urine, and pale stools.[2] The seriousness of disease can be estimated from combined information of clinical examination & specialized biochemical tests. Specialized enzymatic markers are helpful for proper follow-up as delay can be devastating. It can form a platform for malignant & cirrhotic changes of liver: Present study has been undertaken to avoid dreads by simple clinical enzyme study. Serum levels of 5'NT/ALP/AST/ALT/Bilirubin were estimated in sixty cases of clinically diagnosed cholecystitis against forty normal individuals. Purpose was to single out a parameter which is most significant & may help as an endoscope to Surgeon for timely intervention. The study differentiates 5'NT to be superior to ALP due to its specificity and Sensitivity. While elevated AST & ALT levels signify extent of hepatic cell damage, 5”NT specifically signifies the bile duct obstruction or cholestasis as well as hepatic cell damage.

Authors and Affiliations

Dr. Anil Batta

Keywords

Cholelithiasis cirrhotic changes 5'NT/ALP/AST/ALT/Bilirubin ultrasonographic findings.

EP ID EP575336
DOI 10.22192/ijcrms.2019.05.04.005
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