Biliary Tract Disease Flashcards
What are the 3 main factors that lead to gallstone formation
Bile supersaturated w/ cholesterol
Stasis
Nucleation
What are the compositions of the 2 major forms of gallstones?
Cholesterol and calcium bilirubinate
What are the risk factors for choleliethiasis?
Age, Obesity, Female, Rapid wt loss, Fertile, 40’s, Fair skin
What is biliary colic?
Steady ache in the epigastric or RUG associated with gallstones passage through the biliary tract or against the cystic duct
What are the most effective procedures for diagnosing cholelithiasis and acute cholecystitis?
Abdominal Ultrasound (cholesterol stones in GB)
MRCP
HIDA Scan
What is Choledocholithiasis?
Gallstones in the common bile duct
How does choledocholithiasis manifest?
Asymptomatic for years
Symptoms= RUG or epigastric pain and jaundice
What techniques can be used to diagnose a CBD stone
RUQ ultrasound (only detects 50%) Gold Standard= ERCP with sphincterotomy and stone extraction w/ stent placement
What labs can be used to determine the location of the stone?
Typical labs: transaminases >500
Bilirubin >4
What is acute cholangitis?
Acute ascending cholangitis occurs when bacteria becomes trapped behind behind a gallstone that is lodged in the CBD
What constitutes Charcot’s triad? Reynold’s pentad?
Fever, jaundice and pain
Fever, jaundice, pain, shock, and AMS
What is the medical management of cholangitis?
Cholecystetomy and ERCP/drainage of BT to remove stone after treating w/ abx
