Biliary System - Part 3 Flashcards

1
Q

What is the cause of biliary dilatation?

A

Biliary obstruction

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2
Q

What are the clinical findings of biliary dilatation? (4)

A
  1. Asymptomatic
  2. RUQ pain
  3. Jaundice
  4. Elevated direct bilirubin and alkaline phosphatase
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3
Q

What is the US appearance of biliary dilatation? (3)

A
  1. Dilated intrahepatic and/or extrahepatic bile ducts
  2. Parallel channeling
  3. Portal vein may appear flattened
    with progressive dilatation
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4
Q

What are 2 differential diagnosis for biliary dilatation?

A
  1. Normal biliary tree

2. Portal hypertension

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5
Q

What causes biliary atresia? (2)

A
  1. Congenital anomaly

2. Viral infection

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6
Q

What are 4 complications of biliary atresia?

A
  1. Death
  2. Cirrhosis
  3. Cholangitis
  4. Portal hypertension
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7
Q

What is the clinical finding of biliary atresia?

A

Persistent jaundice

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8
Q

What is the US appearance of biliary atresia? (4)

A
  1. Absent hepatic biliary radicles
  2. Small or absent GB
  3. Absent CHD
  4. Hepatomegaly
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9
Q

What are 2 differential diagnosis for biliary atresia?

A
  1. Normal biliary tree

2. Hepatitis

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10
Q

What are the causes of hemobilia? (3)

A
  1. Liver biopsy
  2. Trauma
  3. Vascular malformation
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11
Q

Hemobilia

A

Blood in the biliary tree

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12
Q

What are the clinical findings for hemobilia? (2)

A
  1. Abdominal pain
  2. Hematemesis
    - vomiting blood
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13
Q

What is the US appearance for hemobilia? (2)

A
  1. Low-level echoes within the bile ducts

2. Gravity dependent

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14
Q

What are 2 differential diagnosis for hemobilia

A
  1. Technical error

2. Cholangitis

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15
Q

Pneumobilia

A

Presence of gas in the biliary system

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16
Q

What can cause pneumobilia? (4)

A
  1. Surgical procedure
  2. Trauma
  3. Infection
  4. Incompetent
    sphincter of Oddi
17
Q

What are the clinical findings of pneumobilia? (2)

A
  1. Asymptomatic

2. RUQ pain

18
Q

What is the US appearance of pneumobilia? (3)

A
  1. Hyper echoic focus(i) in the intrahepatic bile ducts

2. Comet-tail reverberation artifact 3. Often centrally located

19
Q

What are 3 differential diagnosis for pneumobilia?

A
  1. Foreign body
  2. Biliary calculus
  3. Arterial calcification
20
Q

What are the clinical findings of Caroli disease? (4)

A
  1. Abdominal pain
  2. Abdominal cramping
  3. Fever
  4. Intermittent jaundice
21
Q

What is the US appearance of Caroli disease? (2)

A
  1. Segmental, saccular, or beaded appearance of the intrahepatic bile ducts
  2. Multiple cystic structures in the liver that communicate with the biliary tree
22
Q

What are 2 differential diagnosis for Caroli disease? (2)

A
  1. Polycystic liver disease

2. Biliary obstruction

23
Q

What is clonorchiasis caused by?

A

Ingestion of raw freshwater fish

24
Q

Clonorchiasis

A

Infectious disease

25
Q

What are the clinical findings for clonorchiasis? (3)

A
  1. RUQ pain
  2. Fever
  3. Leukocytosis
26
Q

What is the US appearance for clonorchiasis? (3)

A
  1. Dilatation of the intrahepatic bile ducts
  2. Diffuse thickening of the bile duct walls
  3. Echogenic focus within the bile duct
27
Q

What are 2 differential diagnosis for clonorchiasis?

A
  1. Cholangitis

2. Cholangiocarcinoma

28
Q

Klatskin tumour

A

Is a cholangiocarcinoma occurring at the confluence of the right and left hepatic bile ducts

29
Q

What are the clinical findings of Klatskin tumour? (6)

A
  1. Jaundice
  2. Acute onset of abdominal pain
  3. Biliary colic
  4. Weight loss
  5. Elevated bilirubin and alkaline phosphatase levels
  6. Mild increase in AST and ALT levels
30
Q

What is the US appearance of Klatskin tumour? (3)

A
  1. Small echogenic mass near the hepatic hilum
  2. Dilatation of the intrahepatic bile ducts
  3. Normal extrahepatic bile ducts
31
Q

What are 4 differential diagnosis for Klatskin tumour?

A
  1. Artifact
  2. . Portal vein thrombosis
  3. Hepatic tumour
  4. Lymphadenopathy