biliary Flashcards
Gallbladder disease two types and risks
Cholelith-Stones
Cholecys- Inflam of gallbladder usually from cholelith
Balance of chole, bile salts, ca+, and Na+=precipitation
Infections or alterations in metab or chole or stasis
immobility, pregnancy, inflam or obstruction, lesions-all cause obstruction
Manifestatons of choelith
Pain is severe-none, more pain when stone is moving or obstructing, may be in shoulder or scap, tachy, diaphoresis, tender RUQ pain,- 3-6 hours after meal or when laying down
Manifestations of chole sis
fat intol, dyspepsia, heart burn, flatulence, inflam with leuko and fever, ab regidity
Total gal stone obstruction symptoms
Jaundice, dark urine, clay stools, pruritus, intol of fat, bleeding tendencies, steatorrhea
Complications of gal bladder disease
Cholesis, gangrenous, subphrenic abcess, pancreatitis, cholangitis, billiary ducts, fistulas, bil cirrhosis, perionitis, choledocholithiasis.
Diagnostic for bil disease
Ultrasound, ERCP, Percutaneoustransoatichosdfkhjldf-Look that up
Labs for bil
Increase WBC, Serum bili/urin bil
Increase liver enzymes, amalase-pancreatic
Tx for bil
Conservative management, if gallstone symp-Cholecystectomy, ERCP with sphincterotomy, endocarp shock lithotrips-takes 1-2 hr and use salts,
Tx for cholecycsitis
Pain control, NSAIDS, anticholenergics, antibiotics, choleystestomy, Fluids and electrolytes, NG tube in severe N/V,
Surgical tx for choleitis
Laperascopic cholecystectomy- Removal through holes, minimal post pain, normal activity in 1 week, few complications, clear lq, same day discharge
or open- removal through right subcostal incision
t-tube-Inserted into the common bile duct,
ESWL
s/s of complete bil obstruction
Steatorrhea, jaundice, dark amber urine, puritis, bleeding, intol to fat foods, clay colored stools
