Biliary System Flashcards
Which ducts join to form the CHD?
right and left hepatic ducts
E 40
Which ducts join to form the CBD?
cystic duct and CHD
E 40
Which ducts join to form the ampulla of Vater?
CBD and Duct of WIrsung in the pancreas
E 40
What does the portal triad consist of?
MPV
CHD
proper HA
E 40
What do the valve of Heister’s control?
controls the bile flow in the cystic duct
E 41
What is Hartmann’s pouch?
abnormal sacculation of the neck of the GB
E 41
What is a phrygian cap?
fold between the body and fundus
E 41
What is a junctional fold?
fold between the body and neck
E 41
Where does the ampulla of Vater empty into?
passes through the sphincter of Oddi into the duodenum
E 41
What is normal GB wall thickness?
less than 3 mm
E 42
What are causes of GB wall thickening?
Cholecysitis hypoalbuminemia ascites hepatitis congestive heart failure pancreatitis E 43
What is sludge associated with?
biliary stasis prolonged fasting hemolysis cystic duct obstruction cholecystitis E 43
What is a gallbladder filled with stones called?
WES sign
E 44
What features are present with acute cholecystitis?
gallstones Murphy's sign diffuse wall thickening gallbladder dilitation sludge E 45
What is considered chronic cholecystitis?
history of multiple episodes of acute cholecystitis, sonographically the same as acute cholecystitis
E 45
What is emphysematous cholecystitis?
acute cholecystitis due to wall ischemia and infection
E 46
What is empyema of the gallbladder?
pus within the gallbladder
E 47
What is gallbladder perforation?
localized fluid collection in the gb fossa
E 47
What is acalculous cholecystitis?
acute cholecystitis without gallstones
E 48
What is a porcelain gallbladder?
calcification of the gallbladder wall
E 49
What is hydrops of the gallbladder?
overdistended gb
asymptomatic
E 49
What size of gallbladder polyps are considered benign?
< 10 mm
E 49
What is cholesterolosis?
lipids deposited into the gallbladder wall appearing like polyps
E 50
What are the sonographic findings of gallbladder carcinoma?
intraluminal mass
asymmetric wall thickening
mass that fills the gb
E 50
What is adenomyomatosis?
hyperplastic changes involving the gallbladder wall forming a thickened wall and diverticula
E 51
What artifact is associated with adenomyomatosis?
comet-tail (reverberation)
E 51
Where in the biliary tract is biliary obstruction most common?
distal CBD
E 52
What are the 2 most common reasons for biliary obstruction?
gallstones
carcinoma of the head of the pancreas
E 52
Obstruction of the biliary tract would elevate which lab values?
alk phos
bilirubin
E 52
What is a normal measurement of the CBD postcholecystectomy?
up to 10 mm
E 53
What is it called when the dilated hepatic duct is parallel to the portal vein?
Shotgun sign
E 54
What is choledocholithiasis?
calculi present in the bile ducts
E 56
What are symptoms of choledocholithiasis?
RUQ pain
jaundice
E 56
What is Mirizzi Syndrome?
extrahepatic biliary obstruction due to a stone in the cystic duct
E 56
What is a common finding with cholangiocarcinoma?
intrahepatic dilatation
E 57
What is cholangitis?
bacterial infection caused from obstruction of the biliary tree.
When is biliary atresia suspected?
when jaundice persists beyond 14 days old
E 58
What is pneumobilia?
air in the biliary tract
E 58
What findings are seen with pneumobilia?
echogenic foci with comet-tail reverberation
E 59
What is a choledochal cyst?
cystic dilitation of the bile ducts
E 59
What are the sonographic findings of choledochal cysts?
two cystic structures in the GB and CBD
E 59
What is Caroli’s disease?
congenital anomaly where there is dilitation of the intrahepatic ducts
E 60
What are the sonographic findings in Caroli’s disease?
multipe cystic structures that converge towards the porta hepatis communitcating with the bile ducts
sludge and calculi can be seen
E 60
What is courvoisier gallbladder?
enlarged non-diseased GB due to obstruction of the CBD
E 60
What lab value is elevated in biliary disease?
conjugated bilirubin and alk phos
E 62
