Biliary Tract Disease Flashcards
name whats labled in pink
what are the components of bile
Bile salt
Cholesterol
Phospholipids (lecithin)
what is the pathogenesis of gallstone?
cholesterol supersaturation
crystal nucleation
gallbladder dysmotility
gallbladder absorbtion
mention 7 risk factors for gallstone
- “Female, Fat, Forty, Fertile”
- Oral contraceptives
- Obesity
- Rapid weight loss (gastric bypass pts)
- Fatty diet
- DM
- Prolonged fasting
- TPN
- Ileal resection
- Hemolytic states
- Cirrhosis
- Bile duct stasis (biliary stricture, congenital cysts, pancreatitis, sclerosing cholangitis)
- IBD
- Vagotomy
- Hyperlipidemia
what are gallstone complications?
gallstone ileus
gallstone pancreatitis
acute cholecystitis
choledochohlithiasis
where is gallstone pain felt?
right upper quadren and radiate to right shoulder and right scapula
symptoms and signs of gallstone
symptoms
severe RUQ pain radiating to shoulder and scapula
provoked by eating fatty meals (fatty dyspepsia)
signa: + murphy sign
gold standered imaging modality to confirm gallstone
ultrasound
whats the diagnostic criteria for cholecystitis
whats the golden period for choleysistitis
within 3 days
managment of choleysistitis
1- resuscitate the patient
if patient came in the golden period
cholesystectomy
if not wait ,, medical treatment anti biotic, fluid
if good response do surgery after 1 month
if dosent respond do surgery
Biliary Colic mangment
analgesia, elective
whats the diagnosis
Acute Calculous Cholecystitis
whats the diagnosis
empyema
Ascending Cholangitis treatment
broad spectrum iv antibiotics
ERCP
symptoms acute pancreatitis and managment
severe epigastric pain radiating to back
supportive (iv fluid antibiotics)
dont discharge before acute phase finishes then do cholcystectomy
what is Mirizzi Syndrome
common hepatic duct obstruction caused by an extrinsic compression from an impacted stone in the cystic duct
