smitha
Forum Elite
Topics: 53
Posts: 236
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Well, here , coz of the injury to the rt. lower ribs, gallstones of the pt. came into notice, rite? Otherwise the pt. was asymptomatic & had no complaints. So, i feel, the answer is d...no treatment.
:roll:
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| Rizwan Rauf
Forum Newbie
Topics: 0
Posts: 1
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Hi,
As gall stones are seen , though in x-Rays, so in order to avoid risk of future disturbance, i think Lithotripsy should be done.
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| Delmar
Forum Senior
Topics: 24
Posts: 142
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well,
gallstones if asymptomatic and the pt is not a high risk pt= no treatment
if diabetic or samonella carrier= cholecystectomy
lithotripsy is now not recognized as a line of treatment as its sucess rate is 30% + induces pancreatitis
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| keri
Forum Senior
Topics: 28
Posts: 61
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no treatment would be the best option becoz the patients has no symptoms
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| guest
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what about the rib fracture????
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| alice8
Forum Guru
Topics: 37
Posts: 643
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it depends on
in my country it would be cholesistectomy
but what about here.really...no treatment?because of no risk factors and the age of the patient...
will anyone enlighten me plz
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| Another visitor
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According to Harrison's 15th:
Cumulative risk (for complications) is very low on expectant management and prophylactic cholecystectomy is not warranted.
(though a very few authorities might prefer surgery in these cases, especially if pt is <50yrs of age)
Those who do develop complications expereince prior warning symptoms in most cases.
Therefore 'No treatment' would be correct for USMLE.
Prophylactic surgery is considered in situations where an underlying condition predisposes to increased risk of complications as Mr. Delmar said... also if stone size >2 cm and congenitally anomalous GB.
Laparoscopic cholecystectomy is now the procedure of choice as pts become symptomatic from cholelithiasis (--->Lithotripsy ~30% recurrence +/- with UDCA or chenodiol---the cumulative treatment cost-- these are less favored---The Cost and Risk vs Benefit)
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| zaki
Forum Guru
Topics: 92
Posts: 398
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no treatment is the best answer regarding incidental finding of cholilithisis and lithotipsy is definetly not the lilne of tx and it can cause complications as delmar said
analgesic for rib # ( not required any specific tx)
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