11.2 Gallbladder and Biliary Tract

Question 1

Biliary Atresia

Answer 1

Failure to form or the destruction of the extra hepatic biliary tree that leads to biliary obstruction

Question 2

What are the clinical presentations of biliary atresia?

Answer 2

• Jaundice (conjugated bilirubin)

- Cirrhosis

Question 3

Cholelithiasis

Answer 3

Gall stones that are due to the precipitation of cholesterol or bilirubin in the bile

Question 4

What is the most common type of gall stone?

Answer 4

Cholesterol Stone

Question 5

Are cholesterol stones radio-opaque or transluscent

Answer 5

Translucent

Question 6

What are the risk factors of cholesterol stones?

Answer 6

• Age
• Estrogen
• Crohn Disease (damage to terminal ileum)
• Cirrhosis
• Native American Ethnicity

Question 7

Do bilirubin stones show up on x-ray?

Answer 7

Yes

Question 8

What are the risk factors of bilirubin stones?

Answer 8

• Hemolysis

- Biliary Tract Infection

Question 9

Biliary Colic

Answer 9

Waxing and waning RUQ pain due to the contraction of the gall bladder against stone lodged in the cystic duct

Question 10

Acute Cholecystitis

Answer 10

Acute inflammation of the gallbladder due to impacted stone in the cystic duct that cause dilatation with ischemia and inflammation

Question 11

How does acute cholecystitis present?

Answer 11

• RUQ pain that radiates to the right shoulder or scapula

- Fever with increased WBCs

Question 12

What will the labs show for acute cholecystitis?

Answer 12

Increased serum alkaline phosphatase

Question 13

Chronic Cholecystitis

Answer 13

Chronic inflammation of the gall bladder due to chemical irritation from longtime cholelithiasis

Question 14

What is a hallmark of chronic cholelithiasis?

Answer 14

Rokitansky-Aschoff Sinuses

Question 15

What is a late complication of chronic cholelithiasis?

Answer 15

Porcelain Gallbladder

Question 16

Ascending Cholangitis

Answer 16

Bacterial infection of the bile ducts that is due to an ascending infection

Question 17

What can increase the incidence of ascending cholangitis?

Answer 17

Choledolithiasis - stone within the duct

Question 18

Gallstone Ileus

Answer 18

Stone enters and obstructs the small bowel and is due to cholecystitis with fistula between the gallbladder and the small bowel

Question 19

Gallbladder Carcinoma

Answer 19

Adenomcarcinoma from glandular epithelium that presents with cholecystitis

Question 20

What is a major risk factor for gallbladder carcinoma?

Answer 20

Gallstones and porcelain gallbladder