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.
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Authors | D K Agarwal, G Choudhuri, J Kumar |
Journal | Scandinavian journal of gastroenterology
(Scand J Gastroenterol)
Vol. 28
Issue 7
Pg. 613-6
(Jul 1993)
ISSN: 0036-5521 [Print] England |
PMID | 8362215
(Publication Type: Journal Article)
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Chemical References |
- Calcium Phosphates
- alpha-tricalcium phosphate
- tetracalcium phosphate
- calcium phosphate, monobasic, anhydrous
- Cholesterol
- calcium phosphate
- Calcium Carbonate
- calcium phosphate, dibasic, anhydrous
- Bilirubin
- Calcium
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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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