Biliary Tract Disease Flashcards
symptoms of gallstones
most asymptomatic
signs of gallstones
biliary colic cholecystitis jaundice pancreatitis bowel obstruction
epidemiology of gallstones
incidence increases with age (>40)
woman >men
risk factors for gallstones
high fat diet obesity pregnancy hyperlipidaemia bile salt loss- Crohn's diabetes dysmotility of gallbladder prolonged fasting total Parenteral Nutrition
causes of gallstones
abnormal bile composition bile stasis infection excess cholesterol excess bilirubin
types of gallstones
mixed 80%
cholesterol
pigment
primary bile duct stones (rare)
why does patient get biliary colic pain
stone impacts in cystic duct
associated with indigestion/nausea
where is pain felt in biliary colic pain
gradual build-pain in right upper quadrant
last 2-6 hours
radiation of pain in biliary colic pain
back/shoulder
causes of severe acute epigastric pain
biliary colic peptic ulcer disease oesophageal spasm MI acute pancreatitis
tests for gallstones
ultrasound CT MRCO/ERCP HIDA EUS
treatment for biliary colic
pain killers
low fat diet
weight loss (if obese)
observe 3-6 months
treatment for recurrent episodes of pain/biliary colic
surgery - cholecystectomy (laparoscopic preferred)
treatment for unfit patient experiencing biliary colic
ursodeoxycholic acid
what is acute cholecystitis
inflammation in gallbladder - obstruction of cyst duct
initially sterile, then becomes infected
