Extrahepatic bile duct stones

Extrahepatic bile duct stones can originate in the bile duct system or can be excreted from the gallbladder to the bile ducts. Most patients with bile duct stones have biliary colic after eating fat and changing their position. This is because the stones move down inside the bile ducts, which stimulates bile duct spasms and blocks bile flow. Abdominal pain occurs mostly under the xiphoid process and right upper abdomen. Paroxysmal severe scalpel-like colic, often radiating to the right back shoulder and back, and has digestive symptoms such as nausea and vomiting. If the bile duct stones cannot be smoothly discharged into the intestinal tract and continue to block the bile duct, it will cause inflammation and infection in the bile duct. At the same time, the internal pressure of the bile duct increases, and the bacteria in the bile duct will spread retrogradely. Pathogens and toxins will pass through the hepatic sinus to the hepatic vein, and then retrograde into the systemic circulation, causing symptoms of systemic infection, such as chills and high fever. If the biliary tract is completely blocked by stones, both acute suppurative cholangitis may occur, which is a very dangerous disease. If the treatment is not timely, the patient will die in a short time. Due to the inability of bile to flow into the intestinal tract, yellow pox, yellow urine, and pale stools will appear after 1 to 2 days of obstruction. If this obstructive jaundice does not heal for a long time, it will lead to chronic cholestatic liver cirrhosis and eventually portal hypertension. Colic and jaundice in many patients with extrahepatic bile duct stones are usually relieved about one week after the attack. This is because the bile ducts dilate after the stones block the bile ducts, so that the impacted stones can be loosened or discharged into the intestine. However, if the internal causes of stones, such as biliary tract infections, biliary strictures, and biliary malformations, cannot be completely resolved, the above symptoms will recur in the near future. The patient had deep tenderness under the xiphoid and right upper abdomen, and sometimes the upper abdomen also touched the enlarged gallbladder.