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Old 08-03-2012
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Correct Answer Black pigment stones


What is the cause of Black pigment gallstones?
1. Intravascular hemolysis
2. Extravascular hemolysis
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Old 08-03-2012
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If bile stones are called black pigment stone then mostly caused by intravascular hemolysis.


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Old 08-03-2012
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my answer--- extravascular hemolysis
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Old 08-03-2012
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Two posts two different answers. Please crosscheck and answer the q guys. Its important
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Old 08-03-2012
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Black pigment stones-sign of chronic extravascular hemolitic anemia where increase in calcium bilirubinate in bile,brown pigment stones-sign of infection in common bile duct
goljan rr p382

Last edited by irakly; 08-03-2012 at 12:14 PM.
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Old 08-03-2012
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Quote:
Originally Posted by irakly View Post
Black pigment stones-sign of chronic extravascular hemolitic anemia where increase in calcium bilirubinate in bile,brown pigment stones-sign of infection in common bile duct
goljan rr p382
Goljan says EXTRAVASCULAR and UW says INTRAVASCULAR
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. Bilirubin stones (pigmented) are composed of bilirubin (Fig. 11.2B).
1. Usually radiopaque
2. Risk factors include extravascular hemolysis (increased bilirubin in bile) and
biliary tract infection (e.g., E coli, Ascaris lumbricoides, and Clonorchis sinensis).
pathoma p117
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In extravascular hemolysis bilirubin binds albumin and is transported to liver for glucuronidation/when excessive precipitates as calcium bilirubinate black stones
Whereas intravascular hemolysis cause decrease in haptoglobin bypassing liver and gallbladder


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Old 08-03-2012
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2. Extravascular hemolysis

simply because pigmented gallstones are found in hereditary spherocytosis, where extravascular hemolysis occurs in spleen.

Never read abt gallstones in intravascular hemolysis so far...
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