bile tract dyskinesia Flashcards
1
Q
definition
A
Functional disorders of the biliary tract.
2
Q
etiology
A
- chronic stress after viral infection
- dysfunc of the CNS
- Vegetative nervous system disorder.
- Chronic cholecystitis.
3
Q
pathogenesis
A
- Hyperkinetic - due to trigger factors, spasm of isthmus, distension causes pain (retention of bile)
- Hypokinetic – > SNS, ↓vagus nerve→spasm of Sphincter Odi. Due to bile stasis, distension causes pain
- Vegetative nervous system disorder (stress) causes hyper or hypotonia of the gall bladder and bile ducts.
- In hypertonia, the spasmic contraction of the bile duct obstructs the lumen, stop bile from flowing out, resulting in bile retention.
- In the hypotonic bile duct, wave contractions of the bile duct which usually causes the excretion of bile are absent, therefore bile retention occurs too.
- Chronic cholecystitis can cause spasmic contractions resulting the same condition.
4
Q
hyper and hypotonic types
A
Criteria
Hypotonic Hypertonic
1. Pain syndrome
Dull, permanent, discomfort, ↑ after food intake
Colicy, spastic, periodic, intensive
- Dyspeptic syndrome
↓pain aft vomiting Often ↑ aft vomiting - Bile portion
Large volume Rapid evacuation, x enlarged - X-ray
GB enlarged & round. Evacuation of bile is slow.
GB not enlarged, tonic condition, small diameter, rapid evacuation or bile. - Treatment
Spasmolytics Choleretics
5
Q
differential diagnosis
A
Cholangitis
High fever, constant spastic pain in the right, jaundice, vena portal thrombosis & infection, leukocytosis
Bile tract dyskinesia
- No organic changes in GB
- disturbances in emotional
- disturbances of motor evacuation func.(X-ray)
- no inflamn symptoms (x fever,x chills)
- 2 diff forms: hypo&hyper-tonic
- Pancreatitis- pain is in epigastric region, belt like.
- Cholecystitis- pain syndrome, dyspeptic syndrome, cardiovascular syndrome, solaric syndrome, asthenic syndrome, allergic syndrome, jaundice syndrome, inflammatory syndrome.
