Biliary Tract and Pancreatic Pathology Flashcards
What is cholelithiasis?
Hard stone-like or gravel-like material formed within the biliary system most commonly the gallbladder
What is found in normal bile?
Micelles of cholesterol, phospholipid, bile salt and bilirubin
Where is bile stored?
in the gallbladder
How is bile released and where?
By CCK into the 2nd part of the duodenum through the common bile duct and the Ampulla of Vater
When do gallstones form?
When there is an imbalance between the ratio of cholesterol to bile salts disrupting micelle formation
Who are most likely to get gallstones
Female
Obese
Diabetic
Genetic
What are pigment stones made up of?
Excess bilirubin which cannot be solubilised in bile salts
What might 2 contributory factors of Gallstones
Gall bladder pH and mucosal glycoproteins
What makes up most gallstones
A mix of stones - cholesterol and pure pigment stones
What can gall stones cause
Obstructive jaundice Empyema Carcinoma Acute pancreatitis Chronic Pancreatitis
What is acute cholecystitis
Gallstones obstructing the outflow of bile that become infected
What might acute cholecystitis cause
Empyema, rupture, peritonitis
Describe the gallbladder wall in chronic cholecystitis
Thickened but not distended
Describe carcinoma of the gallbladder
Rare Adenocarcinoma Associated with gallstones Local invasion of the liver Poor prognosis
Describe carcinoma of the bile ducts
Rare
Associated with UC and PSC
Presents with obstructive jaundice
Adenocarcinoma
