Spontaneous Disappearance of Gallstones | Spontaneous Remission Database

Abstract

A case is presented of a young woman who had several attacks of biliary colic during pregnancy. Three weeks postpartum oral cholecystography showed a normally functioning gallbladder containing many small radiolucent calculi, presumably of cholesterol. Five weeks after the gallbladder x-ray, laparotomy was performed and no gallstones were found. It is suggested that surgery for cholelithiasis in the immediate postpartum period be deferred for several months, and cholecystography routinely repeated before laparotomy, to make sure that the gallstones are still there.

Case Details

Personal Characteristics

Mrs. J. W., age 23, had her first child, a normal full-term delivery, on december 19, 1953. Her father is a physician practicing in massachusetts.

Clinical Characteristics

During her pregnancy she had had many attacks of severe upper abdominal pain, radiating to the right lower posterior chest, associated with nausea and vomiting. She had had a further attack during her labor, and two attacks after delivery. On january 8, 1954, cholecystography 14 hours after the oral ingestion of 6 telepaque tablets showed good filling and excellent concentration of the dye by the gallbladder, which contained many small radiolucent shadows.

Remission Characteristics

On february 18, 1954, dr. John armour explored the abdomen, with the patients father standing behind him. At operation no stones could be palpated in the gallbladder or common bile duct. The gallbladder was removed, and was opened after removal, and found to contain normal clear bile, but no calculous material.

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

Laparotomy, cholecystectomy

Additional Notes

The patients father, who is a physician practicing in Massachusetts, well versed in x-ray, came to Montreal, inspected the x-ray films, concurred in the diagnosis and advised his daughter to wait a few more months before submitting to a cholecystectomy, in order that she might regain her strength following her parturition. The patient, however, refused to delay, prefer ring surgery to further attacks of biliary colic.