Gallbladder cholesterolosis
Introduction
Introduction to gallbladder cholesterol Cholesterolosis of gallbladder is a special type of chronic cholecystitis. Due to the deposition of a large amount of cholesterol ester granules in the basement membrane of gallbladder mucosal epithelial cells, many yellow nodules are formed, which are similar to strawberries, also known as strawberry gallbladder. basic knowledge The proportion of illness: 0.004% - 0.008% Susceptible people: no specific people Mode of infection: non-infectious Complications: gallstones, acute cholecystitis
Cause
Causes of gallbladder cholesterol
Causes:
The cause of gallbladder cholesterolosis is not well defined. It may be due to the stimulation of high concentrations of cholesterol in the bile and the phagocytosis of cholesterol crystals by macrophages on the gallbladder mucosa, which gradually form yellow polypoid lesions that accumulate or protrude from the mucosal surface, or The synthesis of cholesteryl esters is increased due to enhanced activity of acetyl-CoA cholesterol ester acyltransferase (ACAT) in gallbladder mucosal cells.
Pathogenesis
The pathological changes mainly include cholesterol deposition in the basement membrane of gallbladder mucosal epithelial cells. The tissue cells are over-expanded to form yellow nodules. There are fine pedicles connected with the gallbladder. There are two types: one is diffuse, the nodules are covered with gallbladder. The typical shape resembles a strawberry, which is called a strawberry-like gallbladder in pathology; the other is a localized bulge, single or multiple, shaped like a polyp, mostly in the body and neck, with a diameter of less than 1 cm, and the volume grows slowly. It is brittle and easy to fall off. It forms stones under the action of various nucleation factors.
Prevention
Gallbladder cholesterolosis prevention
Prevention: Gallbladder cholesterolosis is a common gallbladder polyposis, a benign lesion, generally not cancerous, clinical manifestations are not specific, the diagnosis mainly depends on B-ultrasound, there is no effective drug treatment, there is obvious clinical Symptoms, large single polyps, short-term rapid increase, gallbladder neck polyps, and suspected cancer, should be performed with cholecystectomy.
Complication
Complications of gallbladder cholesterol Complications gallbladder stones acute cholecystitis
Some may be associated with gallstones or abnormal liver function. Polyps located in the neck of the gallbladder may block the cystic duct and cause acute cholecystitis. Occasionally, polyps fall off the ampulla and cause pancreatitis.
Symptom
Gallbladder cholesterol symptoms Symptoms Abdominal tenderness Blue tympanic membrane dysfunction of liver function Dyspepsia Dull pain Gallbladder stones Gallbladder volume shrinking Gallbladder wall fibrosis Gallbladder hypersensitivity
The disease is equal to men and women, most of the patients are asymptomatic, or only the right upper quadrant swells discomfort, pain, dyspepsia and other similar chronic cholecystitis, occasionally mild tenderness in the right upper abdomen, and some may be associated with gallstones or abnormal liver function The polyp located in the neck of the gallbladder can block the cystic duct and cause acute cholecystitis. Occasionally, the polyp is infiltrated into the ampulla, causing the onset of pancreatitis. Long-term follow-up observation shows that the disease generally does not undergo cancer.
Examine
Examination of gallbladder cholesterol
There are no abnormalities in general laboratory tests.
1. Oral gallbladder angiography can be seen in the gallbladder filling defect, close to the gallbladder wall, does not change with the body position, gallbladder function is often normal.
2. Abdominal CT examination routine scanning interval is too wide, easy to miss diagnosis, it is not listed as a routine examination, mainly used for identification of gallbladder cancer, at this time to the dense layer scanning.
3. Endoscopic ultrasonography The echo characteristics of cholesterol polyps are very fine or strong spots or glare spots with or without echogenic areas, while gallbladder adenomyosis and adenoma or adenocarcinoma sound images are strong echo masses. Multiple microcapsules or comet tail signs.
4.B-ultrasound typical sonogram is a papillary or spherical strong echo group on the wall of the gallbladder. Without accompanying the sound and shadow, the light group does not change with the body position. Some lesions are connected with the gallbladder wall and can be single. Often more hair, the diameter is more than 5mm, generally not more than 10mm, some cases coexist with gallstones at the same time, can be accompanied by sound and shadow, B-ultrasound diagnosis rate can reach more than 90%.
Diagnosis
Diagnosis and diagnosis of gallbladder cholesterol
1. Because the disease is not special in clinical, it can be based on clinical manifestations and signs such as indigestion, middle and upper abdominal fullness or dull upper right abdomen pain.
2. Auxiliary B-mode ultrasound or X-ray cholecystography can be diagnosed.
The disease needs to be differentiated from gallbladder polyps and gallbladder cancer.
