Biliary Tract Flashcards
The neck tapers to for the cystic duct which joins with the common_________ duct to form the common_________ duct.
CHD
CBD
__________&__________ join to form the ampulla of vater
CBD & pancreatic duct ( duct of wirsung)
The gb is located at the inf end of the ______________.
Main lobar fissure
The portal triad consists of
MPV
CHD
PROPER HEP ART
Spiral fold which controls bile flow in the cystic duct
Valve of heister
Abnormal sacculation of the neck of the gb
Hartmanns pouch
Fold in the fundus of the gb
Phrygian cap
The______ passes posterior to the first part of the duodenum and pancreatic head joining the pain panc. Duct( of wirsung) at the ampulla of vater
CBD
The ampulla of vater empties through the duodenal papilla controlled by the ______________
Sphincter of oodi
The most common cause of gb wall thickening
Cholecystitis
Name 5 causes beside cholecystitis that cause gb wall thickening
Hyperalbunemia Ascites Hepatitis CHF Pancreatitis
3 types of jaundice and examples of each
Hepatic jaundice: hep dz such as viral hepatitis
Hemolytic jaundice: destructive RBC such as sickle cell
Surgical jaundice: obstructive pathology
What type of jaundice causes pale stool and dark urine
Surgical jaundice
Sludge is associated with biliary stasis secondary to
* prolonged fasting Hyperalimentation Hemolysis Cystic duct obstruction Cholecystitis
Gs are composed of these 3 things
Cholesterol
Calcium bilirubinate
Calcium carbonate
Cystic duct obstruction may result in : ( hint 5 of them)
Gb perf Acute cholecystitis Pericholecystic abscess Empyema Bile peritonitis
Complications of acute cholecystitis include: (4)
Empyema
Gangrenous cholecystitis
Gb perf
Pericholecystic abscess
In an acute cholecystitis setting an increase of amylase suggest an obstruction at the level of_______
The ampulla of vater
The ampulla of vater empties through the duodenal papilla controlled by _______
The sphincter of oddi
Acute cholecystitis d/t gb wall ischemia and infection
- comet tail artifact d/t presence of gas within the wall from gas- forming bacteria
- more commonly seen in diabetic men
Emphysematous cholecystitis
Purulent material within the gb d\t bacteria containing bile
* symptoms are the same as acute cholecystitis with the addition of fever
Empyema of the gb
Sludge like material with a high concentration of calcium
Assoc. with : chronic cholecystitis cystic duct obstruction
Milk of calcium bile ( limy bile)
Calcification of the gb wall and associated with chronic chole and gb cancer
Porcelain gb
Mucocele of the gb aka_______
Hydrops
Palpable ruq mass -pt asymptomatic
Gb transverse/ap measurement greater than 5cm
Hydrops
Lipids( triglycerides and cholesterol) deposits in gb wall, but has no comet tail artifact. Aka__________
Cholesterolosis
Aka : strawberry gb
Hyper plastic changes involving the gb wall causing overgrowth of the mucosa , thickening of the wall and formation of diverticula. With comet tail( reverberation artifact)
Adenomyomatosis
Elevated lab for biliary obstruction
Alk phos
Conjugated bilirubin
GGT
Most common locations for biliary obstruction
Distal CBD
Gs and carcinoma at head of pancreas
Causes of biliary obstruction
Choledocholithiasis Panc carcinoma Cholangiocarcinoma Cholangitis Mirrizzi syndrome Choledochal cyst Gb carcinoma
