Symptoms and Complications of Gallstone Passage

Clinical Presentation

Patients with gallstone passage typically experience severe, steady epigastric or right upper quadrant pain that lasts for hours, often accompanied by jaundice, fever, and potentially life-threatening complications including cholangitis, pancreatitis, and biliary obstruction, as reported by the European Society of Gastrointestinal Endoscopy 1, 2
Jaundice, a warning sign of complications, occurs due to partial or complete biliary obstruction, according to the American Gastroenterological Association 1, 2
Dark urine and pale stools are implied symptoms of biliary obstruction, as noted by the National Institute of Diabetes and Digestive and Kidney Diseases 3

Fever indicates possible cholangitis, a bile duct infection, as reported by the Infectious Diseases Society of America 1
Ascending cholangitis presents with fever, jaundice, and right upper quadrant pain, according to the American College of Gastroenterology 1
Severe epigastric pain radiating to the back occurs when stones obstruct the pancreatic duct, as noted by the American Pancreatic Association 1
Gallstones cause up to 50% of acute pancreatitis cases, as reported by the National Pancreas Foundation 1

The GallRiks study found that 25.3% of patients with untreated common bile duct stones experienced unfavorable outcomes, including pancreatitis, cholangitis, or obstruction, as reported by the European Society of Gastrointestinal Endoscopy 1, 2
Patients with severe symptoms who fail to improve within 48 hours despite intensive treatment may require urgent ERCP, according to the American Society for Gastrointestinal Endoscopy 3