the prevalence of biliary stone diseases in patient with thyroid disorder

MRCS,; GLAS,; Abdulla Al-Aquli, Hassan; FIBMS,

	the prevalence of biliary stone diseases in patient with thyroid disorder
KUFA MEDICAL JOURNAL
Article 1, Volume 14, Issue 1, 2011, Pages 318-327
Authors
; ; Hassan Abdulla Al-Aquli;
Abstract
Background:-Gallstones are among the most common gastrointestinal illness requiring hospitalization and frequently occur in young, otherwise healthy people with a prevalence of 11% to 36% in autopsy reports. )1,2( Previous studies showed that hypothyroidism is associated with delayed biliary flow in human study.(10) and in animal study. (11) While hyperthyroidism is associated with enhances biliary flow in animal study. (11) Hypothyroidism is the most common secondary cause of hypercholesterolemia, patient with hypothyroidism have serum level of cholesterol approximately 50% higher than level in euthyroid patient, and 90% of all hypothyroid patient have elevated cholesterol level.(12) this will influence the bile solubility. (13) The aims of the study is to evaluate the prevalence of gall stone and common bile duct stone in patient with thyroid disorder and-to evaluate the effects of thyroid function on the biliary stone formation. Patients and method:-This is a prospective study was done in AL-SADER Teaching hospital in AL-NAJAF city in the period between 1st of February 2010 and 1st April 2011. A random sample of population aged 10 ---70 years was included in the study. At first 300 patients were included in the study, but finally only 118 patients were followed properly by at least 2 visits to our hospital surgical unit. Every patient sends for thyroid function test (T3, T4, and TSH.) in the laboratory of our hospital for at least two times, 3 months apart. So our results depend on recording persistent thyroid function status. At the same time patients send for ultrasound of the neck and abdomen especially for gall stone and common bile duct stone also for at least two times to be sure about the presence or absence of the biliary stone. Result:-The study show that 200 patients (84.75%) where female and 36 patients (15.25%) where male .Our study thyroid function test shows that 134 patients (56.78%) euthyroid, 38 patients (16.1%) hypothyroid while 64 patients (27.12%) hyperthyroid. The study also showed that thyroid disorder occurs in female more than male whatever the thyroid status. The ultrasound of the abdomen of our patients showed that only 31 patients (13.14%) have biliary stone, all of them are female patients, while 205 patient (86.86%) did not showed biliary stone .The study show that only 14 patients (10.45%) of those with euthyroid have biliary stone and 15 patients (39.47%) with hypothyroidism have biliary stone while only 2 patients (3.125%) with hyperthyroidism have biliary stone . Conclusion:-1-The prevalence of biliary stone disease is more common in hypothyroid patients compared to euthyroid patients while the prevalence of biliary stone in hyperthyroidism, even in high risk group for cholelithiasis (female gender,fair, fertile, forty or fifty years old , and others) is very low 2- The prevalence of biliary stone disease increase with the decreasing level of thyroid hormone.

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