Observation of NASH and cholecystolithiasis occurence by ultrasonography

NASH is an acquired metabolic disease of the liver caused by accumulation of triglycerides in hepatocytes that is followed by necrobiotic inflammatory reaction, fibrosis and cirrhosis. Obesity, insulin resistance, diabetes mellitus and hyperlipidaemia are important pathogenetic factors of the process. It is known that among patients with cholecystolithiasis and diabetes mellitus in their anamnesis complications of cholecystolithiasis occur much more frequently like among patients without diabetes. Our aim was the observation of the incidence of cholecystolithiasis and its complications in patients with NASH and comparison of cholecystolithiasis incidence between healthy population and population with NASH.

Method: Abdominal ultrasonographical findings were analyzed in patients hospitalized at our department and in outpatients; patients with severe accompanied diseases were excluded of the analysis. The analyzed basic file of patients could be considered as a selected file because of the fact that patients absolved the examination for various clinical complaints; the majority of them were hospitalized at our compartment. The alcohol abuse of the probands was excluded by taking of anamnesis by more persons. In examined groups the gender distribution was also analysed.

Results: Steatosis was described in 33% (62pts) of the 186 examined patients, cholecystolithiasis was described in 20 patients (11%). 16% of patients with steatosis have had cholecystolithiasis or some of its complications. In 33% of patients with cholecystolithiasis NASH was diagnosed by ultrasonography. Cholecystolithiasis and its complications occur two times more frequently in patients with NASH than non-alcoholic steatohepatitis in patients with cholecystolithiasis. Complications of cholecystolithiasis occur more frequently among patients with NASH than in healthy individuals.

Conclusion: Pathogenetic factors of NASH participate in the pathogenesis of cholecystolithiasis. Their common pathogenetic factors bring about cholecystolithiasis faster than the progression of steatosis occurs.