cholelith
Meaning of cholelith: Most of these stones sit silently in the gallbladder for life; the trouble begins only when one moves and blocks a duct.
Definition of cholelith
A cholelith is a gallstone, a solid lump that forms inside the gallbladder or the ducts carrying bile toward the intestine. It develops when substances normally dissolved in bile, usually cholesterol and less often the pigment bilirubin, become concentrated enough to crystallize and harden. Stones may be single or number in the hundreds, and range from grains to several centimeters.
What kinds of stone form?
| Type | What it is made of | What favors it |
|---|---|---|
| Cholesterol stone | Mostly hardened cholesterol, pale yellow | Bile carrying more cholesterol than it can keep dissolved, and a sluggish gallbladder |
| Black pigment stone | Calcium bound to bilirubin pigment | Conditions in which red cells break down faster than usual, and cirrhosis |
| Brown pigment stone | Pigment mixed with fatty material | Infection or obstruction within the ducts themselves |
| Mixed stone | Cholesterol together with calcium salts | The common overlap of the categories above |
Cholesterol stones account for most cases in Western countries. Formation depends on the balance within bile between cholesterol and the bile salts and phospholipids that hold it in solution, and on how completely the gallbladder empties. Anything that tips that balance or slows emptying encourages stones, which is why they become more common with rising age, are more frequent in women, and appear after rapid weight loss and during pregnancy.
Why do most cause no trouble?
A stone lying loose in the gallbladder touches nothing that hurts. Pain appears only when a stone moves into the neck of the gallbladder or into a duct and blocks it, so the organ contracts hard against an obstruction. Most stones never do this. The majority found on scans performed for another reason are noticed once and never cause a symptom, the proportion that eventually announces itself is small, and a stone that has been silent for years is unlikely to start.
What happens when one blocks a duct?
The pattern depends on where it lodges. A stone blocking the outlet of the gallbladder temporarily produces biliary colic, a severe pain under the right ribs that builds over an hour or so and then eases; despite the name it is usually steady rather than gripping in waves. If the blockage persists, the trapped gallbladder becomes inflamed and infected, which is cholecystitis. A stone that passes into the main bile duct obstructs the flow of bile from the liver, turning skin and eyes yellow and darkening the urine, and bacteria multiplying behind that blockage produce a serious infection of the duct system. The same duct joins the drainage from the pancreas just before entering the intestine, so a stone lodged at that junction can inflame the pancreas as well.
Also known as
Used in a sentence
Ultrasound identified a cholelith within the gallbladder during evaluation of the patient's abdominal pain.
Good to know
A cholelith that causes no symptoms is common and often left untreated, while one that blocks bile flow and produces pain or inflammation is managed differently, so the presence of a stone alone does not determine the course of care.
Word origin
Where “cholelith” comes from
Formed from Greek chole, meaning bile, and lithos, meaning stone.