@cardio69 QQQ about Pigment gallstones - redceo123

[ArchivalUser]

So i have some notes saying the cause of black pigment stones is intravascular hemolysis and today i came across UW(offline) that Black pigment stones are due to chronic extravascular hemolysis. So which is it among the two ?

If UW is right about extravacular hemolysis, how does unconjugated bilirubin end up in Gallbladder ? Shouldnt it be conjugated bilirubin in GB in pigment stones composition?

[ArchivalUser]

The Word you missing on yr understanding “Convert” lets try fill the gap >>>>>>>

Generally speaking, How pigment gallstones are formed? We know precipitation of bilirubin in bile. “Black pigment” formed in sterile gallbladder bile insoluble bilirubin (Pigment polymer mix -> carbonate + calcium phospate to know exactly this happen? Just know for step 1 that unconjugated bili How? Excess CB in bile or u could just say SUPRsaturation of that bile -> *UCB ( u know E. Coli or kleb can also produce glucuronidase – can also convert CB water soluble/one can be fact ) -> water insoluble/UCB -> *PH & Ca + mixture of overproduction glycoprotein/organic matrix) and know the asso chronic hemolytic states/SC mech heart valves, know that ↑prevalence cirrhosis (esp alcoholic), Gilbert syndrome, Crohn’s or CF, or it also can be no identifiable ( as poppy said take it ask idiopathic wise word ) bz still not clear cut for it. 1st part of your post was hard from to digest “on yr note” just take UW and my exp you would be fine. GL

[ArchivalUser]

thank you so much cardio69. so i ll just write down again to make sure i didnt miss any point to come back later and check the page again.

1. so bacteria produce the enzyme glucuronidase which converts Conjugated bilirubin to unconjugated bilirubin.
2. and chronic hemolytic states is associated with alcoholic cirrhosis, gilberts, crohns and CF.

so black pigment stones are due to chronic extravascular hemolysis.

Thanks a lot cardio69

[ArchivalUser]

RT.

↑ -Unconjugated bilirubin/UCB in bile ( as u know dissolves only -> micelles norm bile contains only ~ 1 t0 2%) key cz pigment stone formation stone that u need to take home. So, ANY cz ↑ conc of UCB (i.e hemolytic anaemia; so much bilirubin/ hyperbilirubinbilia that the glucuronidase pathway -> conjugation in the liver does not meet demand or ↓ conjugating that liver cannot put up like cirrhosis or nonenzymatic DEconjugation of monoglucuronide bilirubin. The last point that I don’t want u to mix up “bacterial” I just named in deconjugation story is favor more "brown" pigment/soft formation, as in black/ hard.

Try to digest BIG PIC.

Welcome