Pathophysiology of Cholelitiasis

Pathophysiology:
Gallstones, which are concretions that develop in the biliary tract, typically in the gallbladder, are a symptom of cholelithiasis
(see the illustration below). When there are one or more gallstones in the common bile duct, it is known as choledocholithiasis (CBD).
The stage of the disease determines how to treat gallstones.
The most frequently cited supposition for the pathogenesis of chronic and acute cholecystitis is that small and medium-sized
gallstones that migrate from the gallbladder obstruct the cystic duct, or in the case of large gallstones, that they intermittently obstruct
the gallbladder neck. Clinical and histological human studies as well as experimental obstruction of the cystic duct in normal animals
do not, however, support this hypothesis. Although gallstones are occasionally seen in the cystic duct, it is unknown whether these
stones are actually preventing the passage of bile.
Due to the fact that cholelithiasis frequently does not create symptoms, patients may go undetected. The symptoms might range from
stomach pain or nausea to jaundice and biliary colic. Imaging methods are the most accurate way to diagnose gallbladder problems. To
aid differentiate the kind of gallbladder illness and/or detect related problems, laboratory results such as CBC, liver-function testing,
serum amylase, and lipase should be provided. Surgery is the most effective treatment for those with gallbladder disease. Patients
should be encouraged to adopt these healthy behaviors into their lifestyle in order to lower their risk of gallbladder diseases because
food, exercise, and nutrition all have an impact on gallbladder disease.

NCP:
ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION
Subjective: Acute Pain related After 8 hours of Independent: After 8 hours of
“ I have an onset of to biological injury nursing nursing
abdominal Pain agent, as evidenced intervention, the Observe and Assists in intervention, the
radiating to back” by “ I have an onset patient will be able document location, differentiating patient verbalizes
as verbalized by the of abdominal Pain to verbalize feelings severity, and causes of pain, and feelings of relief
patient radiating to back” of relief and characteristics of provides and controls of
as verbalized by the controls of pain, pain. information about pain, and is able to
patient, autonomic and be able to disease progression demonstrate uses of
Objective: responses and, demonstrate uses of and resolution, relaxation
Temperature: 38.1 facial mask of pain. relaxation development of techniques.
BP: 150/70 techniques. complications, and
PR: 110 effectiveness of - Goal Met
RR: 22 interventions.
02 sat: 98
Note the response Severe pain not
Pain scale of 8/10 to medication, and relieved by routine
Face grimace report to the measures may
physician if the indicate developing
Visible appearance pain is not being complications or a
of jaundice relieved. need for further
intervention.
Abdominal
tenderness in RUQ Promote bedrest, Bedrest in
allowing the patient low-Fowler’s
+ Blumberg Sign to assume a position reduces
position of comfort. intra-abdominal
pressure; however,
the patient will
naturally assume
the least painful

position.
Use soft or cotton Reduces irritation
linens; lotion, oil and dryness of the
bath; cool or moist skin and itching
compresses as sensation.
indicated.
Encourage the use

Promotes rest, and
of relaxation
redirecting attention
techniques. Provide
may enhance
diversional
coping.
activities.
Dependent:
Administer Medications
medications as prescribed by
indicated: physicians to
alleviate pain, and
to treat causes and
onset of infections.
Interdependent: Gastroenterologist
Recommend to is the specialist
physician on call, as with expertise in
well as to the the disorders or
gastroenterologist. diseases in the
abdomen.
References:
Behar, J. (2013, February 24). Physiology and pathophysiology of the biliary tract: The gallbladder and sphincter of Oddi-A
Review. International Scholarly Research Notices. from https://www.hindawi.com/journals/isrn/2013/837630/
Lindenmeyer, C. C. (2023, February 14). Postcholecystectomy syndrome - hepatic and biliary disorders. MSD Manual
Professional Edition. Retrieved from
https://www.msdmanuals.com/professional/hepatic-and-biliary-disorders/gallbladder-and-bile-duct-disorders/postcholecystecto
my-syndrome
Douglas M Heuman, M. D. (2022, July 13). Gallstones (cholelithiasis). Practice Essentials, Background, Pathophysiology.
Retrieved from https://emedicine.medscape.com/article/175667-overview
Simore Afamefuna, P. D. C. P. C. of O. M. S. of P. S. (2013, March 20). Gallbladder disease: Pathophysiology, diagnosis, and
treatment. U.S. Pharmacist – The Leading Journal in Pharmacy. Retrieved from
https://www.uspharmacist.com/article/gallbladder-disease-pathophysiology-diagnosis-and-treatment
Lindenmeyer, C. C. (2023, February 14). Cholelithiasis - hepatic and biliary disorders. MSD Manual Professional Edition.
Retrieved from
https://www.msdmanuals.com/professional/hepatic-and-biliary-disorders/gallbladder-and-bile-duct-disorders/cholelithiasis#:~:te
xt=Pathophysiology%20of%20Cholelithiasis,use%20of%20total%20parenteral%20nutrition.

Pathophysiology of Cholelitiasis

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Pathophysiology:

The stage of the disease determines how to treat gallstones.

stones are actually preventing the passage of bile.

food, exercise, and nutrition all have an impact on gallbladder disease.

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Subjective: Acute Pain related After 8 hours of Independent: After 8 hours of

“ I have an onset of to biological injury nursing nursing

patient radiating to back” of relief and characteristics of provides and controls of

patient, autonomic and be able to disease progression demonstrate uses of

Objective: responses and, demonstrate uses of and resolution, relaxation

Temperature: 38.1 facial mask of pain. relaxation development of techniques.

BP: 150/70 techniques. complications, and

PR: 110 effectiveness of - Goal Met

Pain scale of 8/10 to medication, and relieved by routine

Face grimace report to the measures may

physician if the indicate developing

Visible appearance pain is not being complications or a

of jaundice relieved. need for further

tenderness in RUQ Promote bedrest, Bedrest in

allowing the patient low-Fowler’s

+ Blumberg Sign to assume a position reduces

position of comfort. intra-abdominal

the patient will

the least painful

Use soft or cotton Reduces irritation

linens; lotion, oil and dryness of the

bath; cool or moist skin and itching

Encourage the use

alleviate pain, and

to treat causes and

Recommend to is the specialist

physician on call, as with expertise in

well as to the the disorders or

gastroenterologist. diseases in the

Review. International Scholarly Research Notices. from https://www.hindawi.com/journals/isrn/2013/837630/

Professional Edition. Retrieved from

Retrieved from https://emedicine.medscape.com/article/175667-overview

treatment. U.S. Pharmacist – The Leading Journal in Pharmacy. Retrieved from

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