Biliary Colic Flashcards

1
Q

def

A

also known as a gallbladder attack
gallstone temporarily blocks the bile duct
pain in the RUQ which can radiate to the shoulder
pain usually lasts a couple of hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

aetiology

A

obstruction of common bile duct or cystic duct by a gallstone
may be induced by fatty foods
SM of the bile duct contract strongly in an attempt to move the stone, this causes the pain of biliary colic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

risk factors

A

cholesterol gallstone formation risk factors include:

  • age
  • female
  • family history
  • obesity
  • OCP
  • DM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

history

A

pain in RUQ which can radiate to the shoulder
pain can occur after a large fatty meal
sharp pain
pain usually lasts a couple of hours (colicky pain)
nausea & vomiting
indigestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

examination

A

RUQ pain
collins sign (radiation to the right scapular)
patients often present with normal vital signs whereas patients with cholecystitis are usually febrile and present with malaise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

investigations

A
1 USS of RUQ is gold standard
2 bloods
-FBC
-LFTs
-lipase

RAISED bilirubin & alkphos suggests common bile duct obstruction

3 ERCP

  • if lab tests suggest bile duct obstruction
  • therefore ERCP is diagnostic & therapeutic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

management

A

medication
-relief of symptoms (antiemetics for nausea, NSAIDs for pain)
-correction of electrolyte & fluid imbalance
surgery
-cholecystectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

why would antibiotics be given in cholecystitis and not biliary colic

A

in biliary colic, infection is not a concern therefore antibiotics are not required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

complications

A

obstruction of the bile duct by gallstones can lead to cholecystitis or cholangitis or pancreatitis
biliary pain in the absence of gallstones, known as postcholecystectomy syndrome can severely impact QOL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is cholangitis

A

inflammation of the biliary tree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

prognosis

A

if gallstones are not removed from common bile duct or cystic bile duct there is risk of repeated episodes of biliary colic
also a 25% chance of acute cholecystitis in the next 10-20yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

epi

A

annual risk is 2-3%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly