| Question 9 Discussion |
| This gallbladder shows numerous small very dark stones. These are likely to be pigment stones, resulting from hypersaturation of bile with bilirubin. This is associated with excessive hemolysis as might be found in a patient with a congenital hemolytic state - congenital spherocytosis. |
| Cholesterol stones are paler usually although they may be mixed in with bile pigments to give rise to mixed stones. (see pictures below). |
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| Pure cholesterol stones, note yellow color |
| Mixed stones, note the layering that is seen in the stones that are shown in cross section |
| These stones are faceted, the ones above are not. Why does faceting occur? |
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