A gallbladder is opened to reveal numerous composite gallstones. Most stones are mixtures of calcium, bilirubin, and cholesterol. This is cholelithiasis with "cholesterol stones." The prominent yellowish color to these stones is consistent with their predominant cholesterol component. Aging, female sex, and obesity increase the risk for gallstone formation. There can be chronic inflammation in the mucosa and wall of the gallbladder accompanying the stones--chronic cholecystitis. Though most persons with gallstones are asymptomatic, there may be episodes of acute cholecystitis marked by intense right upper quadrant pain. The so-called "pigment stones" composed mainly of dark calcium bilirubinate are seen in populations with chronic hemolysis (hemoglobinopathies) and biliary tract infections.
| Adamidis Dimosthenis of Thessaloniki, GREECE
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