Biliary Tract Disease Flashcards
what are the 2 main biliary tract diseases?
gallstones
biliary tract cancer
what are the symptoms of gallstones?
Most are asymptomatic colic cholecystitis jaundice pancreatitis bowel obstruction
what are the symptoms of gallstones?
Most are asymptomatic biliary colic cholecystitis jaundice pancreatitis bowel obstruction
what can cause gallstones?
abnormal bile composition bile stasis infection excess cholesterol excess bilirubin
what are the components of bile?
cholesterol
bilirubin
phospholipids
sodium and potassium
what type of gallstones are most common?
mixed (80%)
cholesterol (10%)
biliruvin (10%)
name some risk factors for gallstones?
fat female 40s or over fertile foetus (4 Fs) bile salt loss (crohns) diabetes dysmobility of GB prolonged fasting TPN (total parenteral nutrition)
how can gallstones cause a fistula?
continuous inflammation of the gall bladder wall (in close association to duodenum) can cause a fistula to form
what is bilary colic?
where 1 big stone gets stuck leaving the gall bladder
causes severe pain and spasm
how can a gallstone cause acute cholecystitis?
stone stuck in the neck causes obstruction
cause increased pressure on the walls
can cause distension, infection and sever pain
what does an air fluid level in gallbladder in XR suggest?
gas within the gallbladder - possible duodenal fistula
how can gallstones be diagnosed?
US (best, 1st line) CT scan (only to assess complications) MRCP/ERCP HIDA (nuclear test, looks at motility) EUS
how is acute cholecystitis treated?
IV antibiotics + IV fluids
nil by mouth
urgent or interval cholecystectomy
how is acute cholecystitis treated?
IV antibiotics + IV fluids
nil by mouth
urgent(2-5 days) or interval cholecystectomy (several weeks, inflammation died down)
what can occur when gallstones migrate into common bile duct?
jaundice
cholangitis
acute pancreatitis (gets stuck at ampulla where pancreatic duct joins)
