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Biliary Pain Without Gallstones

By

Christina C. Lindenmeyer

, MD, Cleveland Clinic

Last full review/revision Sep 2021| Content last modified Sep 2021
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Pain similar to that caused by gallstones sometimes occurs in people who have no gallstones or who have gallstones too small to be detected by ultrasonography. It is called acalculous biliary pain.

The gallbladder is a small, pear-shaped sac located beneath the liver. It stores bile, a fluid that is produced by the liver and aids in digestion. When bile is needed, as when people eat, the gallbladder contracts, pushing bile through the bile ducts into the small intestine. (See also Overview of Gallbladder and Bile Duct Disorders Overview of Gallbladder and Bile Duct Disorders The liver produces bile, a greenish yellow, thick, sticky fluid. Bile aids digestion by making cholesterol, fats, and fat-soluble vitamins easier to absorb from the intestine. Bile also helps... read more Overview of Gallbladder and Bile Duct Disorders .)

Acalculous biliary pain is most common among young women.

This disorder may develop when bile (produced by the gallbladder) does not pass through the ducts into the small intestine as it usually does. Passage of bile may be slowed or blocked because

Doctors suspect this disorder if people have biliary pain but ultrasonography shows no stones.

Surgical removal of the gallbladder (cholecystectomy) is sometimes done using a flexible viewing tube called a laparoscope. After small incisions are made in the abdomen, the laparoscope and surgical instruments are inserted through the incisions. Doctors then use instruments to remove the gallbladder.

Cholecystectomy may also cause symptoms to resolve if they were caused by gallstones that are too small to be detected by ultrasonography.

Drug therapies have no proven benefit.

More Information

The following are some English-language resources that may be useful. Please note that THE MANUAL is not responsible for the content of these resources.

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Tumors of the Bile Ducts and Gallbladder
Both cancerous and noncancerous tumors of the bile duct or gallbladder are rare. When cancerous, these tumors are almost always fatal. The exception is a cancerous tumor of the gallbladder that is discovered accidentally, such as during gallstone removal surgery. If discovered in this way, the tumor may have been caught early enough to be removed completely, possibly producing a cure. When cancer of the gallbladder is diagnosed, there is almost always a co-existing medical condition found at the same time. Which of the following is the most likely associated medical condition?
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