Biliary disease Flashcards
What is PBC?
Damage to bile ducts, causing scarring and obstruction of bile outlfow
How does PBC present?
Most common in middle age women
Normally an incidental finding
Symptoms; Itch, fatigue, xanthelasma
How do you diagnose PBC?
Positive autoantimitochondrial antibodies
Abnormal LFTs
Liver biopsy
How do you treat PBC?
Urseodeoxycholic acid
What is primary sclerosing cholangitis?
Autoimmune destruction of large and medium sized bile ducts
What is the clinical presentation of PSC?
Recurrent cholangitis
How do you diagnose PSC?
Imaging of the biliary tree
How do you treat PSC?
Maintain bile flow
Monitor for cholangiocarcinoma and colo-rectal cancer
Why do we get gallstones?
Abnormal bile composition Bile stasis Infection Excess cholesterol Excess bilirubin
What are the common risk factors for gallstones?
Age Female High fat diet Obesity Pregnancy Hyperlipidaemia Crohn's disease Diabetes
What are the 5 Fs of gallbladder disease?
Fair, fat, female, fertile and over forty
How do you diagnose gallstones?
Ultrasound
CT scan
MRCP/ERCP
What are the four stages of cholangiocarcinoma?
I - Below the confluence
II - Confined to confluence
III - Extension into right or left hepatic ducts
IV - Extension into both the right and left hepatic duct
What is the only curative treatment for cholangiocarcinoma?
Surgical bile duct and liver ressection
