Calculus (medicine)

An 8-mm kidney stone
Human gallstones, all removed in one patient. Grid scale 1 mm

A calculus (plural calculi), often called a stone, is a concretion of material, usually mineral salts, that forms in an organ or duct of the body. Formation of calculi is known as lithiasis (/ˌlɪˈθəss/). Stones can cause a number of medical conditions.

Some common principles (below) apply to stones at any location, but for specifics see the particular stone type in question.

Calculi are not to be confused with gastroliths.

Types

Calculi are usually asymptomatic, and large calculi may have required many years to grow to their large size.

Cause

In kidney stones, calcium oxalate is the most common mineral type (see Nephrolithiasis). Uric acid is the second most common mineral type, but an in vitro study showed uric acid stones and crystals can promote the formation of calcium oxalate stones.[1]

Pathophysiology and symptoms

Stones can cause disease by several mechanisms:

A number of important medical conditions are caused by stones:

Diagnosis

Diagnostic workup varies by the stone type, but in general:

Treatment

Modification of predisposing factors can sometimes slow or reverse stone formation. Treatment varies by stone type, but, in general:

History

The earliest operation for curing stones is given in the Sushruta Samhita (6th century BCE).[2] The operation involved exposure and going up through the floor of the bladder.[2]

The care of this disease was forbidden to the physicians that had taken the Hippocratic Oath because

See also

References

  1. Grases F.; Sanchis P.; Isern B.; Perelló J.; Costa-Bauzá A. (2007). "Uric Acid as Inducer of Calcium Oxalate Crystal Development". Scandinavian Journal of Urology and Nephrology. 41 (1): 26–31. PMID 17366099. doi:10.1080/00365590600831571.
  2. 1 2 Lock, Stephen etc. (2001). The Oxford Illustrated Companion to Medicine. USA: Oxford University Press. 836. ISBN 0-19-262950-6.
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