Billiary tract disease Flashcards
What are the three biliary tract diseases
Gallstones
Cholecystitis
Ascending Cholangitis
What are gallstones typically made of
Cholesterol and Pigment
What are the RF for Billiary tract disease
Fat
Female
Forty
Fertile
How does Gallstones present
RUQ biliary colic
-Worse after fatty meal
What is the difference between Biliary colic and typical colic
Biliary = Severe long episodes Typical = Comes and goes
How can you diagnose Gallstones
Abdo USS
How is Gallstones treated
Elective Lapro. Cholecystectomy
NSAIDs
IM Diclofenac
How does Cholecystitis presented
RUQ pain and fever
- Pain to the right shoulder = phrenic
- Murphys sign (Press GB and inhale = pain)
How is Cholecystitis Investigated
FBC = Leukocytosis and Neutrophilic
Normal LFT
Abdo USS = Thickened GB wall
How does Ascending Cholangitis present
Charcot’s Triad
- RUQ pain
- Fever
- Jaundice (Pale stool dark urine)
How is Ascending cholangitis Investigated
FBC = Leukocytosis and neutrophilic
Raised Con Bilirubin
Abdo USS = CBD Dilation and gallstones
Gold = MRCP
How do the findings differ between Cholecystitis and Ascending Cholangitis
Both = Neutrophilic and Leukocytosis
Cholecystitis = Thick GB on USS
Asc Cholangitis = CBD Dilation and gallstones on USS
What is the Gold standard test for Ascending Cholangitis
MRCP
How is Cholangitis treated
Lapro. Cholecystectomy <72hr
Give IV Fluid/ Analgesia /Abx
How is Ascending Cholangitis
ERCP( Bile duct clearance) w/ lapro. cystectomy
Consider Sepsis risk
