A 30-year-old patient complains of pain abdomen for 5 days, with similar history in recent past as well. On examination, localized tenderness in right upper quadrant on deep palpation is observed. A slight yellowish discoloration of skin is noted as well. USG examination reveals the following findings. If this patient had associated gallstones, which of the following would it be?
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Cholesterol stone Pigment stone Mixed stone The USG shows BILIARY ASCARIASIS which is associated with pigment gall stones. Unconjugated bilirubin is normally a minor component of bile, but it will increase when infection of the biliary tract occurs that leads to release of microbial b-glucuronidases, which hydrolyze bilirubin glucuronides. Thus, infection of the biliary tract with Ascaris lumbricoides, and others that increases the likelihood of pigment stone formation.
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