Abstract
THE ASSESSMENT OF HYPOTHYROIDISM AS A POSSIBLE ETIOLOGICAL FACTOR FOR GALLSTONE FORMATION

*Dr. Kadhim Hadi Badr Al Salloomee, Dr. Khidhir Abbas Aliwii Al-Shmailawi and Dr. Sahib Baqer Abdulhusein Mudhafar

ABSTRACT

Gall stones are the most common biliary pathology and recent studies show that 10–15% of adult population in USA has gall stones (20 millions), 3% of them underwent cholecystectomy, 85% of them are asymptomatic, 1–4% of them develop symptoms each year, and females are more affected than males 3:1. For decades, there has been a discussion, whether thyroid disorders could cause gallstone disease. Interestingly it has been reported that the risk, in particular, for gall stones, increases in clinical and subclinical hypothyroidism. There are multiple factors that may contribute to the formation and/or accumulation of gall stones in hypothyroid patients, including decreased liver cholesterol metabolism, diminished bile secretion, and reduced Sphincter of Oddi relaxation. This cross sectional study aimed to assess the prevalence of hypothyroidism in patients with gall stones and tried to establish hypothyroidism as a possible etiological factor for gallstones formation. Our study was carried out at department of surgry at Al-Sadir hospital in Baghdad/Iraq on 100 patients with cholelithiasis admitted to the hospital during the period from October 2017 to October 2019. All patients were assessed by detailed clinical history and examination with appropriate investigations in the form of abdominal USG, thyroid function tests and lipid profile. Out of the 100 patients with gallstone, 80 patients were suffering from euthyroid and 20 of them were having subclinical hypothyroidism. The highest number of patients belonged to the age group of 41-50 years (31%), and the majority were females 72 (72%). Out of the 25 patients diagnosed with subclinical hypothyroidism, 19 (76%) were females. The results also showed that 52 (52%) patients presented with complaints of fatty dyspepsia followed by 37 (37) % with biliary colic and 11 (11%) with pain of right hypochondrium. It can be concluded from our study that it is evident that subclinical hypothyroidism is also associated with gall stones and in women with the age group of more than 40. Most importantly, when treating patients with gall stones or microlithiasis, clinicians should be aware of the possible hypothyroid background and consider examining the thyroid function.

Keywords: Hypothyroidism, Gall stones, Subclinical thyroid dysfunction.


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