Crystalline Components of Biliary Calculi

Abstract

A great number of biliary calculi have been studied systematically, mainly by X-ray diffraction methods, with the intention of establishing the crystal forms in which different components separate initially. In order to see whether any phase transitions take place, we have studied fresh calculi immediately after operation as well as calculi removed at operation five years ago. Crystals of cholesterol monohydrate occur in nearly all biliary calculi and this is probably the only form in which cholesterol crystallizes in vivo. A crystalline calcium-bilirubin compound was found for the first time in human calculi; it has earlier been described as occurring in bovine biliary calculi. Calcium carbonate usually occurs as vaterite, but also aragonite and calcite seem to crystallize in vivo. Sodium chloride, though only in small amounts has been found for the first time in biliary calculi.