What are the shapes of gallstones?

Gallstones can be round, oval, polyhedral, irregular, or sand-like in shape. Different stone shapes may present certain differences in diagnosis and management. If symptoms such as right upper abdominal pain or jaundice occur, timely evaluation at a hepatobiliary surgery department is recommended.

1. Round: Mostly cholesterol stones with smooth or slightly rough surfaces, typically 1–2 cm in diameter and relatively hard. These stones develop a rounded shape due to prolonged rolling and friction within the gallbladder. They usually appear singly or in small numbers and have good mobility.

2. Oval: Similar in origin to round stones, these are commonly cholesterol or mixed stones. The long axis is slightly larger than the short axis, with mostly smooth surfaces and medium hardness. They can move slightly with changes in body position within the gallbladder and are less likely to become impacted.

3. Polyhedral: Often seen in pigment or mixed stones. These form polyhedral shapes due to mutual compression and collision among multiple stones. They have relatively rough surfaces with sharp edges, vary in size, frequently occur in clusters, and have relatively poor mobility.

4. Irregular: No fixed pattern in shape—may appear chunky, strip-like, or branched. Often pigment stones or those formed after repeated inflammation in the gallbladder. Surfaces are uneven and bumpy, with brittle consistency prone to fragmentation, possibly accompanied by gallbladder wall thickening.

5. Sand-like: Tiny stone particles resembling sand, mostly less than 0.5 cm in diameter, appearing yellowish-brown or dark brown. These are typically pigment stones that often exist in large quantities within the gallbladder. They easily flow with bile and block bile ducts, potentially causing cholangitis or pancreatitis.

For daily care, maintain a low-fat diet, avoid overeating, eat regularly to promote consistent bile excretion, and undergo periodic ultrasound examinations to monitor changes in stone size and shape. Seek medical attention promptly if symptoms such as abdominal pain or fever occur; do not self-medicate.