2. Predisposing Factors:
Female gender
Fat / Obese
Fertile
Fair complexion
Middle Age / 40 years old and up)
American Indian ancestry / Native American
Multigravid / multiparous woman
Gallbladder, pancreatic, ileal or GI diseases
Precipitating Factors:
High Cholesterol Diet
Use of oral contraceptive pills
Frequent changes in weight
Estrogen Therapy
Increase cholesterol excretion in liver
Gallbladder sludgePregnancy, starvation,
and rapid weight loss
Thickened gallbladder mucoprotein with tiny trapped cholesterol crystals
Supersaturation of cholesterol crystal or microstones
Macrostone formation
Increased motility of gallbladder
Obstruction in bile ducts Bile absorbed by the blood
Gallbladder becomes distended and inflamed
Increased level of conjugated bilirubin
which binds with calcium
Pigmented stones form
Jaundice
Dark colored urine
Grayish feces
Absces
Necrosis
Perforation
Peritonitis
Fever
Biliary colic
Abdominal mass
Pain
Cholelithiasis

3. Pathophysiology (Book)
References:
Huether, Sue E., McCance, Kathryn L. (2000). Understanding Pathophysiology (2nd
ed.). Singapore:
Mosby, Inc.
Porth, Carol Mattson. (2007). Essentials of Pathophysiology: Concepts of Altered Health States (2nd
ed.).
Lippincott Williams and Wilkins.
Smeltzer, Suzanne C., et al. (2010). Brunner and Suddarth’s Textbook of MedicalSurgical Nursing
(12th
ed.). Wolters Kluwer Health/ Lippincott Williams and Wilkins.
Evaluation and Comparison (PATHO)
The patient is female, fat that weighs 90 kg, fertile in the age of 39, has fair
complexion and has a family history of Diabetes Mellitus. Other than that, she prefers to
eat fatty foods and drinks cola’s and juices other than water, she also uses oral
contraceptive pills. According to the book these factors may predispose and precipitate
the patient in acquiring Cholelithiasis.
The patient has abdominal pain prior to admission felt on the URQ and on the
epigastric area while being palpated. According to the book, as the patient feels
abdominal pain on the URQ and epigastric area these means that he/she has obstructed or
inflamed gallbladder. These was proven and supported by the seen calculi in the lumen of
her gallbladder through HBT/ Pancreatic Ultrasound.

4. Increase Estrogen in the body
Decreased Cholecystokinin function
Increase Estrogen in the body
Predisposing Factors:
Female
Fat ( the patient weighs 90 kg)
Fertile (the patient is 39yrs.old)
Fair complexion
Increase cholesterol intake
Precipitating Factors:
Fatty food diet
Use of oral contraceptive pillsIncrease Estrogen in the body
Superaturation of cholesterol crystal
Increase cholesterol
excretion in liver
Gallstone formation
Obstruction in the bile ducts
Gallbladder become inflamed
Abdominal pain in the upper
right quadrant
Cholecystolithiasis