There are a lot of grammatical error.
ABSTRACT (There needs to be some improvement with your abstract. There are a couple of error regarding facts about gallstones. Please review the feedback provided to in your presentation.)
A 19 year-old female had upper abdominal signs and symptoms consistent with gallbladder disease with possibly acute or chronic. She had have an episode for which the physician saw her in April of this year. However, the patient was pregnant at the time. Sonographic images were obtained of the right upper quadrant using gray-scale analysis and showed cholelithiasis.
– Echogenic shadowing foci in the gallbladder, consistent with gallstones.
– There is a small amount of non-specific pericholecystic abscess present.
• Sonographic findings:
– No intrahepatic mass or biliary dilatation is identified. There are echogenic shadowing foci in the gallbladder, consistent with gallstones. There is a small amount of pericholecystic fluid, which is nonspecific but can be seen in association with acute cholecystitis. No gallbladder wall thickening is identified. The common bile duct measures 3.9 mm, which is within normal limits. The pancreas appears unremarkable.
– If there is clinical concern of acute cholecystitis, follow-up hepatobiliary scan is recommended for a more specific evaluation.
EVOLUTION / OUTCOME
• Diagnostic laparoscopy failed to reveal any gross abnormality. The gallbladder was distended but not tense. There was thickening of the wall and what appeared to be fluid within the wall of the gallbladder.
• There was no active bleeding, and the clips were seen to be intact. The patient was injected for postoperative analgesia.
• The patient tolerated the procedure well.
DISCUSSION (You need to provide an in-depth analysis of your topic. There is so much information on gallstones. I would create a list of level I and level II headings to help you organize your material. This particular case study, the patient was pregnant. You could discuss the risk of developing gallstones due to fertility. You did not provide an in-depth analysis of this topic)
The presence of one or more gallstones in the bile duct or in the gall bladder is termed as Cholelithiasis. In the light of the study of Pasternak et al (2014), bile duct of a human body can get affected as the disease of biliary tract has been diagnosed for many years. Majority of the gallstones composed of cholesterol and the etiology behind these gallstones are the excessive secretion of cholesterol from liver. However, it can also be the result of age factor, genetics, and such gallstones are curable. Moreover, bacterial infection should also results in the formation of these gallstones.
The condition of cholelithiasis can become more hazardous if the gallstones follow the hindering of cystic bile, also known as cholecystitis. The pain of the biliary duct should be increased after the obstruction of cystic duct and the condition becomes worse and can cause jaundice. As per Reshetnyak (2012), it requires three major step for the pathophysiology of Cholelithiasis, which include, saturation, crystallization and growth. Moreover, due to these gallstones, the pressure of gallbladder increased, thickening of wall observed, and the supply of blood affected negatively (Allen, 2013).
In conclusion, the physician discussed the likelihood that the signs and symptoms are, at least in part, secondary to the gallbladder. The physician discussed some of the etiology, pathophysiology, diagnostic and treatment options. Also, discussed some of the risks, benefits and possible complications of observation versus operation. The patient appears to understand all of those and presents for cholecystectomy.
REFERENCES (Two of the sources were more than 5 years old. Not allowed)
• Allen, S. N. (2013). Gallbladder disease: pathophysiology, diagnosis, and treatment. US Pharm, 38(3), 33-41.
• Pasternak, A., Szura, M., Gil, K., Brzozowska, I., Maduzia, D., Mizia, E. & Matyja, A. (2014). Metabolism of bile with respect to etiology of gallstone disease—Systematic review. Folia medica Cracoviensia.
• Reshetnyak, V. I. (2012). Concept of the pathogenesis and treatment of cholelithiasis. World journal of hepatology, 4(2), 18.
• Stinton, L. M., & Shaffer, E. A. (2012). Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut and liver, 6(2), 172.