CASE STUDY ON

CHOLELITHIASIS

BY:
JULIE MAE BORLAN
JOANNA CABACUNGAN
EDUARSON RAMOS
 Chapter 1:
Introduction
 Radiology provides a benefit for patients and physicians.
Like X-rays and CT Scans, it allows the physicians to see
bones and surrounding body parts in order to make
diagnosis, watch the progression of an injury or illness,
and guide procedures. Other radiological equipment
such as Ultrasound and Fluoroscopy allow the physicians
to see body tissue in real time. Images from CT Scans,
MRIs and Ultrasound is used to diagnose abnormalities
in the brain, joint tissues and internal organs. Ultrasound
is commonly used to monitor pregnancy (Obstetric
Ultrasound), check the abnormalities in the internal
organs and blood flow of the heart (2D ECHO).
 Ultrasound imaging uses high frequency sound
waves to view soft tissues such as muscles and
internal organs (eg. Liver, Lungs, Spleen, Pancreas,
and Heart) . Because ultrasound images are captured
in real time, they can show movement of the body’s
internal organs as well as blood flowing through
blood vessels.
 The usefulness of ultrasound has now been
demonstrated in determining the stone in
gallbladder or cholelithiasis. It offers an advantage
over other radiologic imaging technologies such as:
absence of ionizing radiation, cost effectiveness, and
the possibility of real-time bedside applications and
image assessment.
 In an ultrasound exam, a hand-held transducer is
placed against the skin. The transducer sends out
high frequency sound waves that reflect off of the
body structures. The returning sound waves, or
echoes, are displayed as an image on a monitor. The
image is based on the pulse repetition frequency,
strength of the sound signal and the time it takes to
return from the patient to the transducer.
Ultrasound uses non-ionizing radiation exposure
that’s why it is safer to use in evaluating diseases like
cholelithiasis.
GALLBLADDER

 Is a small pear-shaped organ which aids in the

digestive process.
 Its function is to store and concentrate bile
 Parts of the Gallbladder

 FUNDUS
 BILE

 A digestive liquid continually secreted by the liver.

The bile in turn emulsifies fats and neutralizes acids
in partly digested food.
 CHOLELITHIASIS

 Cholelithiasis (calculi or galsstones) is the presence

of one or more calculi (gallstone) in the gallbladder.
TYPES:
1. CHOLESTEROL STONE
 They are yellow- green in color,
 Most coomon kind, accounting 80% of gallstone.
2. PIGMENT STONES
 Smaller and darker, they made up of bilirubin, which
comes from a bile, a fluid your liver makes and your
gallv=bladder stores
CHOLELITHIASIS
 RISK FACTORS

 Lifestyle factor
 Overweight or Obese
 Eating diet thats high in fat or cholesterol or low in
fiber
Causes
 symptoms

 Gallstones can lead to pain in upper right abdomen,

you may start to have gallbladder pain from time to
time when you eat foods that are high in cholesterol
such as fried foods and ioly foods, the pain doesnt
usually last more than a few hours
 You may experience

 Nausea
 Vomiting
 Dark urione
 clay-colores stool
 Stomach pain
 Diarrhea
 indigestion
 CHAPTER II

PATIENT PROFILE
 BIOGRAPHIC DATA

 NAME: Ms. KP
 HOSPITAL NUMBER: 213831
 CASE NO. : 48870
 AGE: 22 yrs. old
 GENDER: Female
 CIVIL STATUS: Married
 RELIGION: Hinduism
 PLACE OF BIRTH: Khaireni, Nepal
 DATE OF BIRTH: August 28, 1992
 PARENT’S OCCUPATION: Housekeeper (mother)
 Laborer (father)
 ADMISSION DATA

 NAME OF THE HOSPITAL: CAGAYAN VALLEY

MEDICAL CANTER
 WARD SERVICE: SURGERY WARD
 DATE OF ADMISSION: July 25, 2016,
 TIME OF ADMISSION: 4:10PM
 Mode of Admission: Stretcher
 Admitting Physician: Dr. Comelon
 Attending Physician: Dr. Mantilla
 CHIEF COMPLAINT: Fever, Indigestion, Vomiting,
Pain on the Right Side of the Abdomen.
 ADMITTING DIAGNOSIS: Pain on the right side of
the abdomen
 DIAGNOSTIC EXAMINATION: Chest X-ray, Upper
Abdominal Ultrasound (August 13,2016) include
Complete Blood Count (August 1, 2016), Body Fluid
Analysis (August 5,2016), Laparoscopy
cholecystectomy (August 20, 2016).
 C.Vital Signs upon Admission
 Temperature: 37.1 °C
 Heart rate: 84 bpm
 Respiratory rate: 60 cpm
 Blood Pressure: 120/80
 PAST MEDICAL HISTORY

 She used to take medicine from medical hall in

minor cases. No history of any childhood illness and
no history of past hospitalization.

 PRESENT MEDICAL HISTORY

 Patient KP had fever, vomiting, indigestion, diarrhea

was occurred before 15th of hospitalization and pain
on the right side was from about two months but
pain was dull. Then she used to take pain killers from
medical hall. Pain gradually increased. She came to
the hospital when there was fever vomiting and
diarrhea. She took the medical from OPD of medical
ward before. She was advised to admit on July
25,2016 for surgery.
 CHAPTER 111:
PATIENT’S DISEASE
PARADIGM