Biliary tract pathology Flashcards
What is the other name for gall stones?
Colelithiasis
What is the definition of gall stones?
Stone like material formed within the biliary system - most commonly the gall bladder
What might a patient with bile duct obstruction present with?
Colicky pain epigastric/RH
Jaundice
Steatorrheoa
Dark urine
What do gallstones consist of?
Cholesterol
Bile pigment
Either pure or a mixture of both
What colour are cholesterol stones?
Yellow
What colour are bile pigment stones?
Black
What are some of the risk factors for cholelithiasis?
Fair, forty, female, fertile, fat
I.e. - Caucasian, older, female, more children, obese
In cholecystitis, where is pain typically felt?
Right hypochondrium
In cholecystitis, what is the cause of the initial inflammatory effect?
Reaction to the irritant effects of bile - initially sterile, then becomes infected
What are some of the complications of cholecystitis?
Empyema Rupture Peritonitis Inflammatory adhesions Fistula with second part of duodenum
What happens to the wall of the gallbladder in acute cholecystitis?
Becomes oedematous and infiltrated with acute inflammatory cells
What happens to the wall of the gallbladder in chronic cholecystitis?
Gallbladder wall becomes thickened with fibrosis
How is the diagnosis of gallstones made?
LFTs
Ultrasound
ERCP
MRCP
What is the cause of cholecystitis?
A blockage in the bile duct or gall bladder
What is cholecystitis?
Gall bladder inflammation
What does a positive Murphy’s sign indicate?
Cholecystitis
What is cholangitis?
Inflammation of the bile duct
What is the usual cause of cholangitis?
Bacterial infection secondary to gall stones
What is acute ascending cholangitis?
Cholangitis where bacterial infection is the cause
What is primary sclerosing cholangitis?
A chronic inflammatory condition which results in the fibrosis and destruction of intra-hepatic and extra hepatic bile ducts
What are some of the complications of primary sclerosing cholangitis?
Cholestasis
Hypertension
Liver failure
Which IBD is associated with primary sclerosing cholangitis?
Ulcerative colitis, but occurs in both
What is the symptomatic triad for cholangitis?
Jaundice
Fever/rigors
RUQ pai
