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胆石症

胆石症

伴有胆固醇结石的胆石症患者。图示:剖开的胆囊内可见大量混合石(胆石分为色素性胆石、胆固醇性胆石和混合石三种)。大多数结石由钙、胆红素和胆固醇组成。明显的浅黄色与主要成分胆固醇有关。老龄化、女性、肥胖均为胆石症的危险因素。伴结石形成的慢性胆囊炎往往有胆囊粘膜及胆囊壁的慢性炎症。虽然大多数胆石症病人无临床表现,然而胆囊炎急性发作可致右上腹痛。色素石主要由胆红素钙形成,主要见于溶血和胆道梗阻。

A gallbladder is opened to reveal numerous composite gallstones. Most stones are mixtures of calcium, bilirubin, and cholesterol. This is cholelithiasis with "cholesterol stones." The prominent yellowish color to these stones is consistent with their predominant cholesterol component. Aging, female sex, and obesity increase the risk for gallstone formation. There can be chronic inflammation in the mucosa and wall of the gallbladder accompanying the stones--chronic cholecystitis. Though most persons with gallstones are asymptomatic, there may be episodes of acute cholecystitis marked by intense right upper quadrant pain. The so-called "pigment stones" composed mainly of dark calcium bilirubinate are seen in populations with chronic hemolysis (hemoglobinopathies) and biliary tract infections.


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