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Chemical nature and distribution of calcium compounds in radiolucent gallstones.

Abstract
A high failure rate for radiolucent cholesterol gallstones to dissolve with oral bile acids may be due to the presence of insoluble calcium compounds. Twenty sets of radiolucent gallstones, 7-20 mm in diameter, obtained from 20 patients undergoing cholecystectomy, were cut, and the outer surface, outer rim, middle portion, and central core areas were scanned for calcium by energy-dispersive X-ray microanalysis (EDX) and scanning electron microscopy (SEM). Scrapings from the four areas of each stone were analysed by infrared spectroscopy. A sample of the crushed stone was used for chemical estimation of cholesterol. Eleven (55%) of the 20 cholesterol (84-96% dry weight of cholesterol) stones showed presence of calcium by EDX; the distribution was peripheral in 5, homogeneous in 4, and central in 2. The chemical compound was calcium bilirubinate in 10 and calcium carbonate in 8 stones. Calcium compounds are present in a high proportion of radiolucent gallstones considered suitable for chemodissolution by conventional criteria. Their unrecognized presence may explain the high failure rate of such stones to respond to medical therapy.
AuthorsD K Agarwal, G Choudhuri, J Kumar
JournalScandinavian journal of gastroenterology (Scand J Gastroenterol) Vol. 28 Issue 7 Pg. 613-6 (Jul 1993) ISSN: 0036-5521 [Print] England
PMID8362215 (Publication Type: Journal Article)
Chemical References
  • Calcium Phosphates
  • alpha-tricalcium phosphate
  • tetracalcium phosphate
  • calcium phosphate, monobasic, anhydrous
  • Cholesterol
  • calcium phosphate
  • Calcium Carbonate
  • calcium phosphate, dibasic, anhydrous
  • Bilirubin
  • Calcium
Topics
  • Adult
  • Bilirubin (analysis)
  • Calcium (analysis)
  • Calcium Carbonate (analysis)
  • Calcium Phosphates (analysis)
  • Cholelithiasis (chemistry, diagnostic imaging, pathology)
  • Cholesterol (analysis)
  • Electron Probe Microanalysis
  • Female
  • Humans
  • Male
  • Microscopy, Electron, Scanning
  • Middle Aged
  • Radiography

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