5.4 Gallstones and their complications Flashcards
Whow traditiionally gets gallstones?
Four f’s
- Female, fat, forties, fertile
What are the three types of gallstones?
Cholesterol, pigment, mixed
what are the 3 principle conditions for gallstone formation?
Cholesterol supersaturation
Accelerated nucleation
Gallbladder hyper mobility
What is the most common type of gallstones?
Cholesterol
What is cholecystitis?
Inflammation of teh gallbladder caused by a stone being stuck in the cystic duct
What is the treatment for cholecystitis?
Cholecystectomy
Iv antibiotics, cephalosporin plus metronidazole (and vancomycin in severely inflammed patients)
What is cholangitis?
Infection of the bile duct
What are the symptoms of cholangitis?
Obstructive jaundice, yellow skin, pale stool, dark urine, epigastric pain and fever
What is the treatment for cholangitis?
IV antibiotics and drainage
endoscopy, cholecystectomy
What causes gallstone pancreatitis?
Stone at the common channel of the common bile duct and pancreatic duct
What will you see on blood tests with gallstone pancreatitis?
elevated GGT, ALP, Bilirubin and AST
Elevated pancreatic enzymes (3 x normal)
What is the non operative treatment of gallstone pancreatitis?
gut rest, IV fluid, analgesia, IV antibiotics
What is a gallstone ileus?
A gallstone that has passed into the bowel via cholecysto-enteral fistula causing bowel obstruction
What will you see on an ultrasound for chronic cholecystitis?
thickened gallbladder wall, multiple stones and acoustic shadows
when would you use MRSP (magnetic resonance cholangiopancreatography) for gallstones?
when you need to view the common bile duct
