These slides depict the stages of an acute gallbladder or acute cholecystitis. The first shows the grayish appearance of an edematous gallbladder. The gallbladder wall has swollen and retained water and is edematous. It no longer has the "robin egg blue" appearance of a normal gallbladder.
As the acute cholecystitis progresses, the gallbladder begins to become necrotic and gets a speckled appearance as the wall begins to die.
Finally, the gallbladder undergoes gangrenous changes and the wall becomes very dark green or black.
Fair, fat, forty, female; all adjectives to describe that person most at risk of developing symptomatic gallstones. Gallstones can occur at anytime from childhood to late in life but may not become symptomatic right away. Small children have rarely developed symptomatic gallstones that have had to be surgically removed. Adolescents will at time have recurrent attacks of upper abdominal pain that are related to gallstones. Usually these children have a family history of gallstones. Gallstones can result from rapid weight loss and may form during pregnancy. The stones form as bile salts form precipitates within the stagnant gallbladder. They may become symptomatic when they are 1 mm in diameter or remain silent until the person is in their 90s and has a 4 cm gallstone. The smaller the stone, the more apt they may be to migrate into the common bile duct to produce jaundice or pancreatitis.
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