[Radiolucent pigment gallstones (author's transl)]

Pigment gallstones may be subdivided into three different types: radiolucent and radioopaque stones in the gallbladder and radiolucent stones in the common bile duct. 35 of our patients had radiolucent pigment stones in the gallbladder; 21 of these were followed for years by repeated X-ray examination. There is only little enlargement of these stones as time passes by, however the number of these stones increases continuously. Chemical analysis could be done on such stones in 24 cases. The stones were composed of granular calcium bilirubinate and of asphalt-like products derived from abnormal bilirubin degradation. 5 patients had pigment stones in the common bile duct. These stones contained little cholesterol and exhibited a spongy microstructure characterized by small tubules with a diameter of 1 micrometer. They contained more lipids and bilirubin than the stones collected from the gallbladder and on extraction with organic solvents no asphalt-like residues could be obtained.