From Big Medical Encyclopedia

CONCREMENTS (Latin concrementum heap, accumulation; synonym: stones, joints) — the dense, stony educations which are found in a human body and an animal. Most often determine by this term the educations arising in cavities of bodies or their channels: in bilious and uric ways (see. Gallstones , Urinary stones ), in channels of sialadens (see. Sialolithiasis ), a pancreas, in intestines, in bronchial tubes (see. Broncholithiasis ), in the nasal courses (see. Rhinoliths ), in crypts of almonds, in veins (see. Creams of tartar ), in peritoneal cavities and pleurae, vulval covers of testicles, in joints, etc. This term is applied also in relation to limy deposits in fabric, napr, to petrifikata in the field of a tuberculous focus or a heart attack, at a neck of teeth (see. Dental calculus ). Fecal stones (see), parcels of fibrin in a renal pelvis also sometimes are called To.

Education To. it is caused generally physical. - chemical and fiziol, properties of the environment. Physical. - chemical factors of emergence To. — this disturbance of solubility of the organic and inorganic compounds which are in the weighed or dissolved state in liquids (in urine, bile, a secret of glands) or in fabrics that is promoted by so-called protective colloids, napr, bilious to - you, the holding holesterinester in solution. At change physical. - chemical properties of solution that leads to disturbance of balance in system, the substances dissolved or weighed in liquid drop out in a deposit. Fiziol, the factors causing education To., can be local and the general. Carry disbolism which can be inborn or acquired, connected with food and a way of life of the person, with destructive processes to factors of the general character, with intoxications etc. So, to processes of education To. in uric and bilious ways the slow-moving way of life, feeding habits, feverish states, climatic factors promote. Among local factors an important role in the course of education To. play disturbances of secretory and resorptive activity of body, stagnation of a secret, inflammatory processes. At disturbance of processes of secretion and a reabsorption there is strengthening of solutes and their loss from solution. Inflammatory processes promote stagnation of contents of hollow bodies and channels that leads to loss of rainfall, change of solubility of salts and disturbance of a condition of protective colloids.

When processes of a lithogenesis are caused by exchange disturbances, it is about metabolic To., and at a prevalence of inflammatory changes speak about inflammatory K. V uric ways sometimes meet medicinal To., formed at use of sulfanamide drugs which, being allocated with kidneys, crystallize what acid or neutral reaction of urine especially favors to.

To. have various size, the form, structure and chemical structure depending on the place of emergence and mechanisms of education. One To. can be visible only by means of a microscope (microlites), others reach the considerable sizes (macrolitas). Form K. often repeats contours of that receptacle where they are formed. So, stones in bilious, a bladder have the round or ovoid form, in output channels — a form of the cylinder. Meet single (solitary) To. and multiple. A surface To. can be smooth or rough. In that case, when multiple To. closely adjoin to each other, on their surfaces through contact numerous sides and platforms — fasetirovanny are formed To. Concrements happen very firm or less firm — consistences of chalk or packed sand.

V K. distinguish a kernel and stratifications. A kernel (matrix) of everyone To. organic or colloid substance is, on to-ruyu inorganic matters accumulate. Colloid basis To. consists of mukoproteid and polysaccharides and it can be presented with a shelled epithelium, leukocytes, the condensed slime, proteinaceous rainfall, fibrin, bacterial accumulations etc. Stratifications characterize growth periods To. at the expense of the salts which are dropping out in this colloid system. In some cases some metals and enzymes which are contained in a colloid system can carry out a role of catalysts at formation of such stratifications (e.g., copper at formation of gallstones). Sometimes kernels To. consist of one substance, and consecutive stratifications have other structure — mixed To., napr, holesterino - pigmental and limy To. in a gall bladder. Distinction of structure such combined To. it is connected with the changing conditions of loss of salts that, in turn, depends on complex and various changes in this cavity. Bedded structure To. it is characteristic of colloids, radially located strips — of crystalloids.

Structure To. depends on the substances which are present at places of their education. So, To. bilious ways consist of bilious pigments, cholesterol and salts of calcium, and To. uric ways can incorporate uric to - that, urate salts, calcium oxalate, calcium phosphate, are more rare calcium carbonate, cystine, xanthine. Sometimes To. are presented by some one substance, napr, cholesteric stones of a gall bladder, in other cases To. consist of the proteic matters forming that colloid basis, on to-ruyu salts drop out — colloid and crystalloid To.

In some cases To. do not cause a wedge, symptoms and are found accidentally. Quite often To. are followed by painful manifestations. Getting to narrow canals (bilious channels, an ureter), To. cause their obstruction which is followed by pains, an inflammation, and sometimes a necrosis and perforation of a wall with formation of fistulas. Under pressure of the liquid accumulating in cavities surrounding fabrics are exposed to atrophic and sclerous changes. In kidneys it leads to a hydronephrosis, is more rare to fatty dystrophy, in a liver — to biliary cirrhosis, in a pancreas — to an atrophy of an excretory parenchyma. Complex kliniko-morfol, the changes accompanying existence To., allows to allocate the independent diseases which are characterized defined a wedge with a picture (see. Cholelithiasis , Nephrolithiasis ) and demanding conservative or operational treatment.

Bibliography: Avtsyn And, Item. Introduction to geographical pathology, page 226, M., 1972; B about r and with about in and - X r about m of e of N to about V. M. An urolithiasis in Altai Krai and some of its features, Barnaul, 1973, bibliogr.; Weinberg 3. C. Stones of kidneys, M., 1971, bibliogr.; And its l in M. A. Cholelithiasis, Ufa, 1975, bibliogr.; Davydovsky I. V. General pathology of the person, page 148, M., 1969; Kiselyova A. F. and B of l and-godarov V. N. Pathological anatomy and pathogeny of a nephrolithiasis, Arkh. patol., t. 36, No. 8, page 3, 1974, bibliogr.; Novikov I. F. Stones of ureters, L., 1974, bibliogr.; Lehrbuch der speziellen Pathologie, hrsg. v. L. H. Kettler, S. 533, Jena, 1976; Walter J. B. a. I s r an e 1 M. S. General pathology, Edinburgh, 1974.

G. M. Mogilevsky.