Biliary System Flashcards
What is acalculus cholecystitis?
Inflammation without associated GB stones
What hormone causes the GB to contract? Where is it produced?
Cholecystokinin –produced in the duodenum
What is Courvoisier GB?
the clinical detection of an enlarged, palpable GB caused by a biliary obstruction in the area of the pancreatic head. Pt’s will have painless jaundice
What is the IV administration of nutrients and vitamins called?
Hyperalimentation
What are Rokitansky-Aschoff sinuses?
Tiny pockets within the GB wall
What are risk factors and predisposing factors for stones?
pregnancy obesity increased parity gestational diabetes estrogen therapy rapid weight loss programs hemolytic disorder total parental nutrition
Polyps should measure under?
5mm –otherwise they may be suspicious for carcinoma
Acalculus cholecystitis is most commonly seen in?
Children, hospitalized patients and those who are immunocompromised
Is GB carcinoma associated w gall stones?
Yes
Also associated w porcelain GB and chronic cholecystitis
The most common metastatic disease of the GB is?
Melanoma
The cystic artery is a branch of the?
Right hepatic artery
The middle layer of the GB wall is the:
fibromuscular layer
WES sign denotes:
A GB filled with cholelithiasis
Intermittent obstruction of the cystic duct by a gallstone results in:
chronic cholecystitis
A nonmobile, nonshadowing focus seen in the GB lumen is likely a:
polyp
The sequela of acute cholecystitis that is found more often in diabetic patients is:
Emphysematous cholecystitis
Cholesterol crystals within the Rokitansky-Aschoff sinuses are found with:
Adenomyomatosis
Courvoisier’s GB is most associated with:
Pancreatic head mass
What type of choledochal cyst is most common?
Type 1 – a fusiform dilation of the CBD
What type of choledochal cyst are true diverticula of the bile ducts and are very rare?
Type 2
What type of choledochal cyst are confined to the intraduodenal portion of the CBD?
Type 3
What’s the difference between type 4a and 4b choledochal cysts?
A- multiple intrahepatic and extrahepatic biliary dilations
B- only extrahepatic dilations
Caroli syndrome is associated with?
Renal tubular ectasia (medullary sponge kidneys)
What’s the difference between primary and secondary choledocholithiasis?
Primary - stones likely caused by diseases that cause strictures/dilations to the bile ducts
Secondary - migration of stones from GB to CBD
Where are CBD stones most likely to be located?
Distal portion or at the ampulla of Vater
What are the symptoms of Mirizzi syndrome?
Pain
Jaundice
Fever
What’s the difference between Mirizzi syndrome and acute/chronic cholecystitis?
Sonographically very similar, but the dilation will be to the CHD and there will be surrounding edema
Metastases to the biliary tree most commonly come from?
Breast, colon and melanoma
