Pigmented gallstones

An RP-HPLC technique was employed for the analysis of bilirubin, one of the main components of pigment gallstones. The aim of the study was the determination of the inhibition of chlolesterol crytallization under bilirubin deconjugation. Bilirubin in rat bile was measured in an ODS column (250 X 4.5 mm. i.d. particle size 5 pm). Separation was... 

Matsumura et al. (1996) analyzed hypercholeresis in dogs with pigment gallstones after cholate infusion. 

Owing to the greater sensitivity of PBC patients to pharmaceutical preparations, different pharmacons, e. g. phenothiazines, contraceptives, oestrogens and anabolic steroids, can reinforce cholestasis and the clinical symptoms, thus aggravating the course of disease. Gallstones are frequently detectable (35-40%) as a rule, they are pigment gallstones. Administration of clofibrate is con-... 

Alvaro, D., Angelico, M., Gandin, C., Corradini, S.G., Capocaccia, L. Physico-chemical factors predisposing to pigment gallstone formation in liver cirrhosis. X Hepatol. 1990 10 228 -234... 

As a result of the crises entailing destruction of the red blood cells and the frequently required blood transfusions, liver siderosis develops. This may subsequently lead to fibrosis in some cases. Episodic cholestasis can be witnessed. In progressive siderosis, treatment with deferoxamine is indicated. Pigment gallstones (s. figs. 

Pigmented gallstones are associated with conditions in which the bilirubin load is increased, such as hemolytic anemia, or when bilirubin becomes insoluble (i.e., deconju-gated), such as occurs with cholestasis or chronic biliary infections. 

The cholesterol excreted with the bile is poorly water-soluble. Together with phospholipids and bile acids, it forms micelles (see p. 270), which keep it in solution. If the proportions of phospholipids, bile acids and cholesterol shift, gallstones can arise. These mainly consist of precipitated cholesterol (cholesterol stones), but can also contain Ca " salts of bile acids and bile pigments (pigment stones). 

Gallstones Calcified cholesterol, radiopaque stones, radiolucent bile pigment stones... 

Swirl 2 g of crushed gallstones in a 25-mL Erlenmeyer flask with 15 mL of 2-butanone on a hot plate for a few minutes until the solid has disintegrated and the cholesterol has dissolved. Filter the solution while hot, taking precautions to warm the stemless funnel prior to the filtration. Its dirty-yellow appearance is from a brown residue of the bile pigment bilirubin, a metabolite of hemoglobin. 

The main cause of cholelithiasis (presence or formation of gallstones) is precipitation of cholesterol in bile. Elevated biliary concentrations of bile pigments (bilirubin... 

Hemolysis causes jaundice and an increased risk of pigment (bilirubin) gallstones. 

Gallstones occasionally contain black pigments which consist of polymers of bilirubin derivatives. To study whether any bile pigment metal complex is also... 

Addition of cupric chloride to bilirubin in sodium hydroxide solution resulted in precipitation of a black substance, which was proved to be a bilirubin-Na-Cu complex formed by coordination of copper to sodium bilirubinate. The black pigments of the gallstone may thus possibly include some metal complexes of bile pigments, although identification of such substances in the bile or in gallstones had not yet been definitely established at the time of this investigation. 

Shioda (82) investigated the effect of dietary constituents on gallstone formation in golden hamsters. Like Dam, he found that hamsters on a low-fat diet frequently formed cholesterol gallstones. The addition of unsaturated fats (codliver oil, sesame oil) prevented cholesterol stones but allowed the development of amorphous pigment stones. Cholesterol stones correlated well with increased cholesterol and decreased bile acids and phospholipids in hepatic bile that was consequently supersaturated with respect to cholester-... 

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