biliary tree Flashcards
what can cause gallstones
abnormal bile composition, bile stasis, infection, excess cholesterol/ bilirubin
who is likely to get gallstones
5F’s = female, 40, fair, fat and foetus (pregnant)
what are the symptoms of gallstones (cholelithiasis)
RUQ that becomes more localised, colicky (worse when/after eating) radiates to shoulder and back, nausea
what invx can be done for gallstones
USS = best, bloods and LFT’s (raised gGT and ALP), MRCP and CT
what treatment can be given for gallstones
analgesia, reduced cholesterol, urseodeoxycholic acid and lap cholectamy (best)
what are the main risks of gallstones
gallstone ileus (small bowel obs), jaundiec, cholangitis (bile duct inflam), choleysytitis (GB inflam), pancreatitis
what is ascending cholangitis
inflammation of the bile ducts often caused by gallstones where area gets INFECTED
what are the main symptoms of cholangitis
RUQ pain, fever, jaundice (encephalopathy, low BP)
what investigations would you do for cholangitis
USS, CT, MRI, bloods (raised CRP, WCC, bilirubin, ALP)
what treatment would you do for cholangitis
AB’s and drain
what is acute cholecystitis
inflammation of the GB often caused by gallstones and blocks cystic duct
what are the symptoms of acute cholecystitis
RUQ pain radiates to shoulders and back, initially colicky –> constant nausea and vomiting
what are the investigations for acute cholecystits
USS
what are the main treatments for acute cholecystitis
ABs and lap choley
what is the most common biliary tree cancer
cholangiocarcinoma
