TY - JOUR
T1 - Physical chemistry of bile detailed pathogenesis of cholelithiasis
AU - Itani, Malak
AU - Dubinsky, Theodore J.
PY - 2017/3/27
Y1 - 2017/3/27
N2 - Despite the overwhelming prevalence of cholelithiasis, many health care professionals are not familiar with the basic pathophysiology of gallstone formation. This article provides an overview of the biochemical pathways related to bile, with a focus on the physical chemistry of bile. We describe the important factors in bile synthesis and secretion that affect the composition of bile and consequently its liquid state. Within this biochemical background lies the foundation for understanding the clinical and sonographic manifestation of cholelithiasis, including the pathophysiology of cholesterol crystallization, gallbladder sludge, and gallstones. There is a brief discussion of the clinical manifestations of inflammatory and obstructive cholestasis and the impact on bile metabolism and subsequently on liver function tests. Despite being the key modality in diagnosing cholelithiasis, ultrasound has a limited role in the characterization of stone composition.
AB - Despite the overwhelming prevalence of cholelithiasis, many health care professionals are not familiar with the basic pathophysiology of gallstone formation. This article provides an overview of the biochemical pathways related to bile, with a focus on the physical chemistry of bile. We describe the important factors in bile synthesis and secretion that affect the composition of bile and consequently its liquid state. Within this biochemical background lies the foundation for understanding the clinical and sonographic manifestation of cholelithiasis, including the pathophysiology of cholesterol crystallization, gallbladder sludge, and gallstones. There is a brief discussion of the clinical manifestations of inflammatory and obstructive cholestasis and the impact on bile metabolism and subsequently on liver function tests. Despite being the key modality in diagnosing cholelithiasis, ultrasound has a limited role in the characterization of stone composition.
KW - Bile
KW - Biochemistry
KW - Cholelithiasis
KW - Cholesterol
KW - Metabolism
KW - Ultrasound
UR - http://www.scopus.com/inward/record.url?scp=85016125524&partnerID=8YFLogxK
U2 - 10.1097/RUQ.0000000000000287
DO - 10.1097/RUQ.0000000000000287
M3 - Article
C2 - 28350710
AN - SCOPUS:85016125524
SN - 0894-8771
VL - 33
SP - 229
EP - 236
JO - Ultrasound Quarterly
JF - Ultrasound Quarterly
IS - 3
ER -