ABSTRACT
Gallstones are a common reason for acute abdominal pain, and admission to hospital. There are many reasons why gallstones produce abdominal pain, some of which may be life threatening. It is important to note the numerous problems that acute pancreatitis causes, and the associated systemic manifestations. Age, obesity and smoking are risk factors for many diseases. In the patient presenting with epigastric pain the important disease processes are gallstones producing biliary colic, peptic ulcer and pancreatitis. Multiparity is an additional risk factor for gallstones. Biliary colic is caused by the gall bladder contracting under the influence of cholecystokinin, forcing a stone into the gall bladder outlet/cystic duct. Acute cholecystitis is acute inflammation of the gall bladder, caused in 90% of cases by persistent obstruction of the cystic duct by a gallstone. Multiple factors contribute to inflammation in an obstructed gall bladder.
