Biliary disease Flashcards
what is cholelithiasis
gallstones
risk factors for gallstones
female fertile 40/50s fat DM IBD rapid weight loss oestrogen + OCP
what materials are gallstones made of
cholesterol
pigment
mixed
what is biliary colic
symptomatic gallstones with cystic duct / CBD obstruction
symptoms of biliary colic
RUQ/epigastric pain +- radiation to right shoulder tip comes and goes usually after a fatty meal worse at night/early morning N+V
clinical findings in biliary colic
RUQ tenderness
what is Courvoisiers sign
palpable GB in context of painless jaundice is unlikely to be gallstones
what is the gold standard imaging for biliary colic
USS
management of biliary colic
leave alone if asymptomatic
analgesia and antiemetics
consideration for elective cholecystectomy
what is acute cholecystitis
stone impaction at the neck of the gallbladder resulting in inflammation of the GB
inflammation is bacterial in acute cholecystitis, true or false
false, initially it is sterile then it becomes infectious
symptoms and signs of acute cholecystitis
RUQ pain +- radiating to right shoulder tip
fever / ^ WCC
N+V
+- jaundice
what is Murphy’s sign and where is it seen
in acute cholecystitis
pressing on the RUQ creates pain on inspiration (provided there is no pain of the LUQ)
imaging for acute cholecystitis
USS
MRCP
management of acute cholecystitis
NBM IV fluids analgesia IV antibiotics - cefuroxime delayed cholecystectomy
what is cholangitis
inflammation of the bile ducts usually due to infection
what is the name of the triad of symptoms associated with cholangitis
Charcot’s triad
list the symptoms of Charcot’s triad
RUQ pain
fever/rigors/^WCC
Jaundice
cholangitis is a medical emergency, true or false
true
Need IV antibiotics ASAP
list complications of gallstones
cholecystitis cholangitis pancreatitis perforation gallstone ileus
what is primary biliary cirrhosis PBC
autoimmune condition affecting small bile ducts
what is primary sclerosing cholangitis
autoimmune condition affecting med-large sized bile ducts
with which condition is PSC associated
UC
what is cholangiocarcinoma
malignancy of the bile ducts
