BILIARY TRACT Flashcards
A SPIRAL FOLD WHICH CONTROLS BILE FLOW IN THE CYSTIC DUCT
VALVE OF HEISTERS
AN ABNORMAL SACCULATION OF THE NECK OF THE GB
HARTMANNS POUCH
A FOLD BETWEEN THE BODY AND FUNDUS OF GB
PHYRGIAN CAP
GB IS LOCATED AT THE INFERIOR END OF WHAT FISSURE
MAIN LOBAR FISSURE
RT AND LT HEPATIC DUCTS JOIN TO FORM THE
COMMON HEPATIC DUCT
_____ AND ________ (DUCT OF WIRSUNG) JOIN TO FORM THE
AMPULLA OF VATER
BLOOD SUPPLY TO THE GB IS FROM THE
CYSTIC ARTERY
A FOLD BETWEEN THE BODY AND THE NECK (INFUNDIBULUM) OF THE GB
JUNCTIONAL FOLD
THE CBD PASSES _____ TO THE DUODENUM AND PANCREATIC HED JOINING THE MAIN PANCREATIC DUCT AT THE AMPULLA OF VATER
POSTERIOR
NORMAL GB WALL THICKNESS
< 3MM
THE MOST COMMON CAUSE OF GB WALL THICKNESS IS
CHOLECYSTITIS
CALCIUM BILIRUBINATE GRANULES AND CHOLESTEROL CRYSTALS; ASSOCIATED WITH PROLONGED FASTING
SLUDGE (TUMEFACTIVE SLUDGE IF THICK AND MAY APPEAR AS MASS)
CHOLELITHIASIS=
GALLSTONES
A GALLBLADDER FILLED WITH STONES MAY BE SEEN AS A STRONG SHADOW IN THE RUQ THIS IS CALLED THE
DOUBLE ARC OR THE WES SIGN
-GB WALL INFLAMMATION DUE TO CYSTIC DUCT OBSTRUCTION
-RUQ PAIN, FEVER, LEUKOCYTOSIS
-MURPHYS SIGN
ACUTE CHOLECYSTITIS
-MULTIPLE PREVIOUS EPISODES D/T ACUTE CHOLECYSTITIS
-SONOGRAPHICALLY DOES NOT APPEAR DIFFERENT FROM ACUTE CHOLECYSTITIS
CHRONIC CHOLECYTITIS
-ACUTE CHOLECYSTITIS D/T GB WALL ISCHEMIA AND INFECTION
-DIABETIC PATIENTS
-GAS IS FOUND IN GB WALL OR BILIARY TREE
-CHAMPAGNE SIGN
EMPHYSEMATOUS CHOLECYSTITIS
PROCEDURE FOR CREATING AN ANASTAMOSIS OF THE CBD TO JEJUNUM
CHOLEDOCHOJEJUNOSTOMY
-RUQ PAIN, FEVER, LEUKOCYTOSIS
-GB FILLS WITH PURULENT MATERIAL
EMPYEMA OF THE GB
THE MOST COMMON SITE OF PERFORATION? LOCALIZED FLUID COLLECTION IS THE GB FOSSA IS COMMONLY SEEN
GB FUNDUS
ACUTE CHOLECYSTITIS W/O THE PRESENCE OF GALLSTONES, TYPICALLY SECONDARY TO EVENT IN CRITICALLY ILL PATIENTS IS CALLED
ACALCULOUS CHOLECYSTITIS
-ASSOCIATED WITH CHRONIC CHOLECYSTITIS AND OBSTRUCTION
-SLUDGE LIKE MATERIAL WITH HIGH CONCENTRATION OF CALCIUM
MILK OF CALCIUM BILE(LIMY BILE)
CALCIFICATION OF THE GB WALL ASSOCIATED WITH CHRONIC CHOLECYSTITIS AND GB CANCER
PORCELIN GB
-ASSOCIATED WITH KAWASAKI DISEASE
-COMMONLY CAUSED BE AN IMPACTED STONE IN THE NECK OF THE GB OR IN THE CYSTIC DUCT
HYDROPS, ALSO KNOWN AS MUCOCELE OF THE GB
POLYPS THAT ARE LESS THAN ___MM IN DIAMETER ARE UNLIKELY TO BE CANCEROUS.
10, SIZE IS THE MOST IMPORTANT INDICATOR OF MALIGNANCY
-STRAWBERRY GB
-LIPIDS (TRIGLYCERIDES AND CHOLESTEROL) ARE DEPOSITED IN THE GB WALL
CHOLESTEROLISIS ALSO KNOWN AS HYPERPLASTIC CHOLECYSTOSIS
S/S ARE NONSPECIFIC AND MIMIC CHOLECYTITIS
GB CARCINOMA
-HYPERPLASTIC CHANGES INVOLVING THE GB WALL CAUSING OVERGROWTH OF THE MUCOSA, THICKENING, AND FORMATION OF DIVERTICULA
-ASSOCIATED WITH COMET TAIL ARTIFACT (REVERBERATION)
ADENOMYOMATOSIS
BILIARY OBSTRUCTION IS MOST LIKELY DUE TO PATHOLOGY IN THE
DISTAL CBD
TWO MOST COMMON LESIONS OF BILIARY OBSTRUCTION
GALLSTONES AND CARCINOMA OF THE HEAD OF THE PANCREAS
BILIARY OBSTRUCTION ELEVATED LAS INCLUDE
ALP,GGT, CONJUGATED BILIRUBIN
OBSTRUCTION OF THE DISTAL CBD RESULTS IN PROGRESSIVE DILATION OF THE
EXTRAHEPATIC AND INTRAHEPATIC BILIARY TREE
NORMAL CBD MEASUREMENT
LESS THAN OR EQUAL TO 5MM
CBD INCREASES WITH AGE WITH ___MM BEING UPPER LIMITS FOR THE ELDERLY
10
THESE SIGNS REFER TO THE DILATED HEPATIC DUCT ADJACENT TO THE PORTAL VEIN
PARALLEL CHANNEL SIGN OR SHOTGUN SIGN
A HORMONE THAT IS RELEASED INTO THE BLOOD BY THE INGESTION OF FATTY FOODS, CAUSES GB CONTRACTION
CHOLECYSTOKININ
POSTIVE RESULT OF FATTY MEAL=
DUCT INCREASES IN SIZE
MOST COMMON CAUSE OF EXTRAHEPATIC OBSTRUCTIVE JAUNDICE; FORMATION OR PRESENCE OF CALCULI IN THE BILE DUCTS
CHOLEDOCHOLITHIASIS
CHOLEDOCHOLITHIASIS LABS THAT INCREASE ARE
ALP,GGT, CONJUGATED BILIRUBIN
EXTRAHEPATIC BILIARY OBSTRUCTION DUE TO AN IMPACTED STONE IN THE CYSTIC DUCT CAUSING EXTRINSIC MECHANICAL COMPRESSION OF THE COMMON HEPATIC DUCT
MIRIZZI SYNDROME; ASSOCIATED FINDINGS INCLUDE CYSTIC DUCT STONE AND INTRAHEPATIC DILATION
A CHOLANGIOCARCINOMA LOCATED AT THE HEPATIC HILUM (JUNCTION OF THE RIGHT AND LEFT HEPATIC DUCT) RESULTING IN INTRAHEPATIC BUT NOT EXTRAHEPATIC DILATION
KLATSKIN TUMOR
BILE DUCT ADENOMCARCINOMAS TYPICALLY ORIGINATE WITHIN THE
CHD OR CBD
CHOLANGIOCARCINOMA MOST COMMON FINDING IS
INTRAHEPATIC BILE DUCT DILATION AND WEIGHTLOSS
IS A DISEASE CAUSE BY THE PARASITIC ROUNDWORM ASCARIS LUMBRICOIDES; COMMONLY FOUND IN SOUTHEAST ASIAN COUNTRIES
ASCARIASIS
INFLAMATION OF THE BILIARY TREE
CHOLANGITIS
CHOLANGITIS AS ASSOCIATED WITH THE CHARCOT TRAID WHICH CONSIST OF
RUQ PAIN,FEVER, AND JAUNDICE
MOST COMMON CAUSE OF CHOLANGITIS
CHOLEDOCHOLITHIASIS
ELEVATED LABS OF CHOLANGITIS ARE
CONJUGATED BILIRUBIN, ALP,GGT,AMYLASE AND LIPASE AND LEUKOCYTOSIS
BILIARY ATRESIA IS ASSOCIATED WITH THE
TRIANGULAR CORD SIGN AND POLYSPLENIA SYNDROME
IS THE MOST SUCCESSFUL IN THE TREATMENT OF BILIARY ATRESIA IF PERFORMED BEFORE 90 DAYS OF LIFE
KASAI PORTOENTEROSTOMY
PNEUMOBILIA IS AIR IN THE BILIARY REACT AND COMMONLY ASSOCIATED WITH AN
ERCP (ENDOSCOPIC RETROGRADE. CHOLANGIOPANCREATOGRAM)
CHOLEDOCHAL CYSTS ARE MORE PREVALENT IN
ASIA
A CONGENITAL ANOMALY OF THE BILIARY TRACT CHARACTERIZED BY MULTIFOCAL SEGMENTAL DILATION OF THE INTRAHEPATIC BILE DUCTS
CAROLI DISEASE
“CENTRAL DOT SIGN”
CAROLI DISEASE
MOST COMMON CAUSE OF MALIGNANT NEOPLASM OBSTRUCTING THE BILIARY TREE
PANCREATIC ADENOCARCINOMA
PANCREATIC ADENOCARCINOMA TYPICALLY CASUES
CORVOISIER GB
REFERS TO THE DILATION OF THE CBD AND THE DUCT OF WIRSUNG
DOUBLE DUCT SIGN
AN INFLAMMATION AND FIBROSIS OF THE INTRAHEPATIC AND EXTRAHEPATIC BILE DUCTS
PRIMARY SCLEROSING CHOLANGITIS
PRIMARY SCLEROSING CHOLANGITIS ELEVATED LABS VALUES ARE
ALP, BILIRUBIN,GGT,ALT/AST
AN AUTOIMMUNE DISORDER RESULTING IN CHOLESTATIS DUE TO DESTRUCTION OF HTE SMALL INTAHEPATIC BILE DUCTS LEADING TO CIRRHOSIS
PRIMARY BILIARY CHOLANGITIS
THIS LAB VALUE INCREASES WITH ANY BILE DUCT OBSTRUCTION
ALP
THE _____ DO NOT FILTER UNCONJUGATED BILIRUBIN AS THEY ARE BOUND TO ALBUMIN.
KIDNEYS
THE PRESENCE OF BILIRUBIN IN THE URINE INDICATES
CONJUGATED HYPERBILIRUBINEMIA
THE END PRODUCT OF HEMOGLOBIN BREAKDOWN
BILIRUBIN
