Comparative Study of Clinical Profile of Patients with Solitary versus Multiple Gall Stone

Abstract

Objective: To compare the clinical profiles of patients with solitary versus multiple gallstones, focusing on symptom distribution and diagnostic findings.

Methodology: This prospective comparative study was conducted in the Department of General Surgery at AIMS Hospital, Muzaffarabad, from July to December 2023. Patients aged ?18 years with newly diagnosed solitary or multiple gallstones confirmed by ultrasound were included. Exclusion criteria were common bile duct stones, previous cholecystectomy, gallbladder malignancy, pregnancy, and incomplete records. Patients were grouped as solitary or multiple gallstones based on imaging. Demographic data, clinical presentation, and associated features were documented using a structured proforma. Statistical analysis was performed using chi-square tests, with p <0.05 considered significant.

Results: Among 58 patients, 34 (58.6%) had solitary gallstones and 24 (41.4%) had multiple. The mean age was 46.2 ±13.3 years; females predominated (82.8%). Most patients were symptomatic (93.1%). Common symptoms included upper abdominal pain (86.2%), nausea/vomiting (89.7%), right shoulder pain (65.5%), and back pain (60.3%). Jaundice was rare (8.6%). Comparative analysis revealed no statistically significant differences in individual symptoms between groups (p >0.05). However, severe pain was significantly more frequent in solitary stone patients (37.9%) compared to multiple stones (12.1%) (p =0.035).

Conclusion: Both solitary and multiple gallstones commonly present with similar symptoms such as abdominal pain and nausea. However, solitary gallstones were associated with a higher prevalence of severe pain. These findings emphasize the need for individualized assessment in gallstone management.