Biliary Tract Disease Flashcards
name four different kinds of gallstones?
mixed
cholesterol
pigment
primary bile duct stones
what is the most common type of gallstone?
mixed
what is the most rare type of gallstone?
primary biliary duct stones
name two possible complications of gallstones
biliary colic
cholecystitis
what causes biliary colic?
stone impacts in the cystic duct
where does pain from biliary colic present?
RUQ, radiates to the back and shoulder
what symptoms are associated with biliary colic?
indigestion
nausea
what is acute cholecystitis?
inflammation of the gallbladder
what causes acute cholecystitis?
obstruction of the cystic duct
what investigations can be done to diagnose gallstones?
ultrasound
MRCP/ERCP
how is biliary colic treated?
analgesia
low fat diet
lose weight if obese
what is done if episodes of biliary colic are recurrent?
cholecystectomy
how is recurrent biliary colic treated if the patient is unfit for surgery?
ursodeoxycholic acid 10mg/kg/day
how is acute cholecystitis treated?
IV antibiotics and fluids
nil by mouth
urgent cholecystectomy
what can cause further complications of gallstones?
migration of stones into the common bile duct
name three complications of gallstones that have become impacted in the common nile duct
jaundice
cholangitis
acute pancreatitis
what is a possible complication of gallstones if one enters the intestine?
gallstone ileus
name four symptoms of gallstones in the CBD
itch
nausea
anorexia
abnormal LFTS
how is a gallstone in the CBD diagnosed?
MRCP
what can be used to remove a stone from the CBD?
ERCP
what are the two main causes of acute pancreatitis?
alcohol and gallstones
how does a gallstone enter the small intestine?
travels through a fistula between the gallbladder and the duodenum
how does gallstone ileus present?
with a distal small bowel obstruction
what is the treatment for gallstone ileus?
urgent laparotomy to remove the stone
what is cancer of the bile duct called?
cholangiocarcinoma
how does cholangiocarcinoma present?
jaundice
weight loss
anorexia
lethargy
when does cholangiocarcinoma present?
usually late
how is cholangiocarcinoma treated?
liver and bile duct resection
how can cholangiocarcinoma be palliated?
insertion of a biliary stent
