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Re: Question re Stones in the liver
Telman Views: 1,650
Published: 15 years ago
This is a reply to # 761,260

Re: Question re Stones in the liver

That is the problem in asking someone who has insufficient experience that is gained in a classroom dissecting pig livers. I guess because your friend has a white coat it makes all the difference.

There is plenty written about intra-hepatic stones if look.

This adds more evidence that doctors are inadequate trained in some disciplines.

Intra-hepatic stones (IHS) have been described as early as the 16th century; however, the first detailed description of the disease in English literature was not until 1906.1 IHS is more prevalent in eastern Asia, with the highest incidence being in Taiwan, followed by China, Hong Kong, Korea, Malaysia and Japan. There also seems to be a high incidence in Brazil. On the other hand, the Western world and India have a low incidence of IHS.

In the Western world, IHS is generally thought to be secondary to stones originating in the gall bladder or primarily resulting from benign strictures cysts or malignant biliary tumours.

In the East, however, IHS is regarded as a separate entity altogether. The majority of IHS is associated with recurrent ďpyogenic Cholangitis Ē (bacterial infection of the biliary tract) which affects both genders equally and has a peak incidence in the third and fourth decades of life. It is more common among poor people and those in rural rather than urban areas.

The diet of the Orient, predominantly high in carbohydrate and low in fat and protein, has been implicated as an etiological factor for RPC. As saturated fat causes the hormone cholecystokinin to be released which contracts the gallbladder, a diet low in saturated fats could conceivably lead to biliary stasis, predisposing to IHS. A low-protein diet is also responsible for a decreased level of ďglucaro-1.4-lactoneĒ, leading to formation of calcium bilirubinate stones.

Recent studies from Korea report that presently about 40%-50% of IHS are of mixed variety, and some stones being pure cholesterol stones have lent support to the dietary theory.

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