biliary tract and gallbladder Flashcards
gallstone are more common in
women
how can crohns lead to gallstones
cause bile salt loss
gallstone pathophysiology
if the concentrations of bile vary gallstones may form
cholesterol stones
formed by crystallisation of cholesterol in micelle surface - cholesterol precipitated out of bile to form solid stones
5 F for gallstones
female fair fat forty fertile
causes of cholesterol gallstones
bile supersaturated with cholesterol - excess cholesterol
not enough bile acids ro salts
gallbladder stasis or inactivity
can cholesterol be seen on XR
no - radiolucent
pigment stones
excess bilirubin combines with calcium
are pigment stones seen on XR
yes - calcium
how do pigment stones form
excess bilirubin due to excess haemolytic e.g. haemolytic anaemia
management of gallstones
MRCP to view
ERCP to remove
if gallstones effect the CBD what happens
jaundice, itch, nausea, anorexia
Cholecystitis
inflammation of the gallbladder
what is Cholecystitis usually associated with
gallstones lodged in cystic duct
clinical features of Cholecystitis
pain - midepigastric. can lead to nausea and vomiting
pain can radiate to right shoulder and RUQ
murphys sign positive
acute Cholecystitis
Gallstones obstructing outflow of bile and subsequent infection
acute Cholecystitis CF
fever, inc WCC, RUQ pain
chronic Cholecystitis
chronic inflammation with/out colic
chronic Cholecystitis CF
flatulence, fat intolerance
Cholecystitis treatment
IV antibiotics/fluid
NJ nil by mouth
US to confirm
urgent cholecystectomy
biliary colic
a symptom of gallstones
gallstone lodged in bile duct
biliary colic CF
RUQ pain - radiate to back or shoulder
no fever, WCC, or jaundice
biliary colic pain
typically inc for 15 min and then sustain for 6 hours till gallstone dislodges
biliary colic diagnosis confirmed by
US
