biliary tract disease Flashcards
risk factors for gallstones?
- female
- obesity/rapid weight loss
- increase in age
- first degree relatives who have it
3 different types of gallstones?
- cholesterol
- pigment
- mixed
how are asymptomatic gallstones found?
-incidentally found in ultrasound exam for other problems
symptoms of gallstones?
- biliary colic
- Murphy’s sign
Acute cholecystitis symptoms?
RUQ pain (>24 hours)
+/- fever
Tender on RUQ of abdomen
Positive Murphy’s sign
investigations for gallstones?
- USS first line
- CT scan
what will gallstones look like on ultrasound?
- distended gallbladder
- Increased wall thickness (>4mm)
- peri cholescystic fluid
- positive sonographic Murphys sign
complications of acute cholecystitis?
- mucocele
- empyena of gall bladder
- emphysematous cholecystitis
- perforated gallbladder
- cholecystoenteric fistula
what is mucocele?
obstruction of cystic duct and secretion of mucus to the gallbladder
treatment for mucocele?
urgent cholecystectomy
if unfit for surgery requires draining
what to do if empyena of gallbladder?
-urgent cholecystectomy
treatment for emphysematous cholecystitis?
urgent cholecystectomy
treatment for perforated gallbladder?
if pericholecystic abscess- percutaneous drainage
biliary peritonitis due to free perforation- emergency laparotomy
what is cholecystoenteric fistula?
chronic perforation into adjacent viscus
treatment for cholecystoenteric fistula?
laparotomy is needed for extraction of stone, cholecystectomy and closure fistula
