A 40-year old woman, mother of five children, obese, complains of vague upper abdominal pain and frequent indigestion. From time to time she has fatty, foul smelling stools. There is no evidence of jaundice. An X-ray revealed opacification in the region of the gallbladder.

Gallbladder removed from this patient. The probe is in the patent cystic duct. Why is the patient anicteric? What type of stones are these?

Another gallbladder, filled with stones. Describe the stones and discuss their chemical composition.

Compare these gallstones with those in the previous image. Take notice of the color and the size and shape of the stones.

Solitary gallstone. Discuss the clinical features of solitary vs. multiple gallstones.

Fragment of the solitary stone examined under polarized light. What is the nature of these crystals?

Question for Class Discussion