Calculus (medicine)

## Contents

* 1 Overview
* 2 Common stone diseases
* 3 Aetiology
* 4 Pathophysiology & Symptoms
* 5 Diagnosis
* 6 Treatment
* 7 See also

## Overview

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A calculus is a stone (a concretion of material, usually mineral salts) that forms in an organ or duct of the body. Stones cause a number of important medical conditions.

## Common stone diseases

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A number of important medical conditions are caused by stones:

* Nephrolithiasis (kidney stones)
* Can cause hydronephrosis (swollen kidneys) and renal failure
* Can predispose to pyelonephritis (kidney infections)
* Can progress to bladder stones and bladder outlet obstruction
* Cholelithiasis (gallstones)
* Can predispose to cholecystitis (gall bladder infections) and ascending cholangitis (biliary tree infection)
* Can progress to choledocholithiasis (gallstones in the bile duct) and gallstone pancreatitis (inflammation of the pancreas)
* Rhinolith (nasal calculus)

Stones can also be asymptomatic.

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

## Aetiology

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* From an underlying abnormal excess of the mineral, eg. with elevated levels of calcium (hypercalcaemia) that may cause kidney stones, dietary factors for gallstones.
* Local conditions at the site in question that promote their formation, e.g. local bacteria action (in kidney stones) or slower fluid flow rates, a possible explanation of the majority of salivary duct calculus occurring in the submandibular salivary gland.
* Bezoars are a type of calculus found in the intestines of mostly ruminant animals and may be composed of inorganic or organic constituents.

## Pathophysiology & Symptoms

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Stones can cause disease by several mechanisms:

* Irritation of nearby tissues, causing pain, swelling, and inflammation.
* Obstruction of an opening or duct, interfering with normal flow and disrupting the function of the organ in question.
* Predisposition to infection (often due to disruption of normal flow).

## Diagnosis

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

* Clinical history and physical examination can be sufficient in some cases.
* Imaging studies are often needed.
* Some stone types (mainly those with substantial calcium content) can be detected on X-ray and CT scan.
* Many stone types can be detected by ultrasound.
* Factors contributing to stone formation (as in #Aetiology) are often tested:
* Laboratory testing can give levels of relevant substances in blood or urine.
* Some stones can be directly recovered (at surgery, or when they leave the body spontaneously) and sent to a laboratory for analysis of content.

## Treatment

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Again, treatment varies by stone type, but in general:

* Modification of predisposing factors can sometimes slow or reverse stone formation.
* Medications can sometimes be used.
* Surgery is sometimes needed.
* Infections due to stones have to be treated with antibiotics and/or surgery.
* Pain is managed with medication.

## See also

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* Rhinolith (nasal calculus)
* Salivary duct calculus

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