Hepatic abnormalities in cholelithiasis.
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Biomedical subjects
Publications and source records attributed to R Maqsood.
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A study of 118 newly diagnosed patients with gallbladder disease during a two year period showed that the frequency of gallbladder cancer was 8.4% and cholelithiasis played a significant role in its etiology. No remarkable differences were observed in the clinical and biochemical findings between the benign and malignant disease of gallbladder.
The composition of gall stones removed surgically from 31 patients was determined by microchemical analysis. Twenty six had mixed infective, 2 cholesterol and 3 pigment stones. All the stones consisted of combination of various constituents in varying amount. Bilirubin was detected in the centre and peripheral layers of all, protein was found in the centre of 84.6% and cholesterol in the centre of 54% and the peripheral layers of all the gall stones. The findings in this study suggest that infection is the most likely cause of biliary lithogenesis.
Amino acid imbalance ratio was determined in apparently healthy Pakistanis and patients with hepatitis and cirrhosis of the liver. The ratio was normal in 75% of the patients with actue viral hepatitis but in only 5% with cirrhosis of the liver. The ratio was abnormal in 25% cases of acute viral hepatitis possibly due to aminoaciduria. The abnormal ratio in cirrhosis of the liver indicated the functional capacity for albumin synthesis and correlated well with serum albumin concentration.
Amino acid imbalance ratio was determined in apparently healthy Pakistanis and patients with hepatitis and cirrhosis of the liver. The ratio was normal in 75% of the patients with acute viral hepatitis but in only 5% with cirrhosis of the liver. The ratio was abnormal in 25% cases of acute viral hepatitis possibly due to aminoaciduria. The abnormal ratio in cirrhosis of the liver indicated the functional capacity for albumin synthesis and correlated well with serum albumin concentration.
During a period of 16 months 114 patients with cholelithiasis were studied. The diagnosis was confirmed by cholecystogram in 41 cases, by surgery in 28 and both surgery and the x-ray in 45 cases. There were 100 females and 14 males and their average age was 43.2 years. The average number of pregnancies in females was 6.5. Clinically the jaundice was observed in 9% and the gall bladder was palpable in 47% of cases. Cholelithiasis appeared to be related to increased parity but not to the body weight.
The levels of cholesterol, calcium and bilirubin were determined in the serum and gall stones in 47 cases with cholelithiasis. The mixed stones were observed in 87.5%, high cholesterol stone in 8.5% and high bilirubin stones in 4.2%. Serum and stone cholesterol levels were inversely proportional and the bilirubin levels were directly proportional to each other.