Biliary colic Flashcards
What is biliary colic?
Biliary colic is caused by gallstones passing through the biliary tree.
What are the ‘4 F’s’ risk factors for gallstones?
The ‘4 F’s’ are: Fat, Female, Fertile, and Forty.
How does obesity contribute to gallstone risk?
Obesity is thought to enhance cholesterol synthesis and secretion.
Why are gallstones more common in women?
Gallstones are 2-3 times more common in women due to oestrogen increasing the activity of HMG-CoA reductase.
What role does pregnancy play in gallstone risk?
Pregnancy is considered a risk factor for gallstones.
What are other notable risk factors for gallstones?
Other notable risk factors include diabetes mellitus, Crohn’s disease, rapid weight loss, and certain drugs.
What is the pathophysiology of biliary colic?
Biliary colic occurs due to increased cholesterol, decreased bile salts, and biliary stasis.
What causes the pain in biliary colic?
The pain occurs due to the gallbladder contracting against a stone lodged in the cystic duct.
What are the features of biliary colic?
Features include colicky right upper quadrant abdominal pain, worse postprandially and after fatty foods, with possible radiation to the right shoulder.
What symptoms are common in biliary colic?
Nausea and vomiting are common.
How does biliary colic differ from other gallstone-related conditions?
In biliary colic, there is no fever and liver function tests/inflammatory markers are normal.
What is the primary investigation for biliary colic?
Ultrasound is the primary investigation.
What is the management for biliary colic?
Elective laparoscopic cholecystectomy is the management.
What percentage of patients have gallstones in the common bile duct during cholecystectomy?
Around 15% of patients are found to have gallstones in the common bile duct (choledocholithiasis) at the time of cholecystectomy.
What complications can arise from gallstones?
Possible complications include acute cholecystitis, ascending cholangitis, acute pancreatitis, gallstone ileus, and gallbladder cancer.
