Chapter 3: The Gallbladder Flashcards
inflammation of the gallbladder without associated gallstones
acalculous cholecystitis
the sudden onset of gallbladder inflammation
acute cholecystitis
benign hyperplasia of the gallbladder wall
adenomyomatosis
when a polyp appears to be a round object, like a ball, that is stuck to the gallbladder wall
“ball on the wall” sign
pain located in the RUQ in the area of the GB
biliary colic
the effect of dirty shadowing, reverberation, or ring-down artifact caused by gas or air bubbles produced by bacteria within the nondependent (typically anterior) gallbladder wall
champagne sign
the surgical removal of the GB
cholecystectomy
the hormone produced by the duodenum that causes the GB to contracty
cholecystokinin
the presence of gallstone(s) within the biliary tree
choledocholithiasis
gallstone(s)
cholelithiasis
a condition that results from the disturbance in cholesterol metabolism and accumulation of cholesterol typically within a focal region of the GB wall; may be diffuse and referred to as a strawberry GB
cholesterolis
results from intermittent obstruction of the cystic duct by gallstones
chronic cholecystitis
partially digested food from the stomach
chyme
artifact caused by several small reflective interfaces
comet-tail artifact
the clinical detection of an enlarged, palpable GB caused by an obstruction in the area of the pancreatic head, typically caused by a pancreatic head mass
courvosier GB
chronic inflammatory bowel disease that leads to thickening and scarring of the bowel walls, leading to chronic pain and recurrent bowel obstructions
Crohns disease
the duct that connects the gallbladder to the common hepatic duct
cystic duct
having two gallbladders that are often, but not always, paired with their own cystic ducts
duplication of the gallbladder
abnormal distention of an organ with air or gas
emphysematous
the presence or collection of pus
empyema
a gallbladder that is highly mobile and thus prone to torsion
floating gallbladder
the twisting of the vascular supply to the gallbladder
gallbladder torsion
an outpouching of the gallbladder neck
Hartmann pouch
a condition that results in the destruction of red blood cells
hemolytic anemia
situation in which the gallbladder is completely filled with tumefactive sludge, causing the gallbladder to appear isoechoic to the liver tisue
hepatization of the gallbladder
an enlarged gallbladder; also referred to as mucocele of the gallbladder
hydropic gallbladder
the intravenous administration of nutrients and vitamins
hyperalimentation
a group of proliferative and degenerative gallbladder disorders, which includes both adenomyomatosis and cholesterolysis
hyperplastic cholecystosis
abnormal low level of albumin in the blood;
hypoalbuminemia
performing sonographic imaging between the ribs
intercostal sonographic imaging
rare anomaly of the biliary tree where the main hepatic ducts drain directly into the gallbladder and the gallbladder drains directly into the common bile duct; may lead to childhood jaundice, enlarged gallbladder, and intermittent abdominal pain
interposition of the gallbladder
a gallbladder that is completely surrounded by the hepatic parenchyma
intrahepatic gallbladder
a fold in the neck of the gallbladder
junctional fold
a condition associated with vasculitis and can affect the lymph node, skin, and mucous membranes; also referred to as mucocutaneous lymph node syndrome
Kawasaki disease
an elevated white blood cell count
leukocytosis
pain directly over the gallbladder with applied probe pressure
Murphy sign
the total number of completed pregnancies that have reached the age of viability
parity
fluid around the gallbladder
pericholecystic fluid
inflammation of the peritoneal lining
peritonitis
gallbladder variant when the gallbladder fundus is folded onto itself
Phyrgian cap
the calcification of all or part of the gallbladder wall
porcelain gallbladder
after a meal
postprandial
tiny pockets within the gallbladder wall
Rokitansky-Aschoff sinuses
a life-threatening condition caused by the body’s response to systemic infection; also referred to as blood poisoning; results in a number of issues including low blood pressure, rapid heartbeat, and fever
sepsis
a gallbladder that has one or more septa within its lumen; a gallbladder with several septa; may be referred to as a multiseptate gallbladder
septate gallbladder
an illness resulting from another disease, trauma, or injury
sequela
form of hemolytic anemia typically found in Africans or people of African descent; characterized by dysfunctional sickle-shaped red blood cells
sickle cell disease
folds located within the cystic duct that prevent it from collapsing and distending
spiral valves of Hester
complication of acute cholecystitis characterized by pus accumulation within the gallbladder
suppurative gallbladder
the feeding of a person intravenously
total parenteral nutrition
thick sludge
tumefactive slude
shadowing from the gallbladder fossa produced by a gallbladder that is completely filled with gallstones
wall-echo-shadow sign
The sonographic sign of gallbladder torsion when color Doppler is applied to the spiraled, twisted cystic artery
whirlpool sign
rare chronic gallbladder infection characterized by intramural accumulation of inflammatory cells, noted sonographically as asymmetrical thickening of the gallbladder wall and intraluminal echogenic debris
xanthogranulomatous cholecystitis
hourglass appearance of the gallbladder
bilobed gallbladder
appears as thin separations within the gallbladder
septate gallbladder
gallbladder is folded onto itself
phyrgian cap
most common gallbladder variany
phyrygian cap
outpouching of the gallbladder neck
hartmann pouch
prominent fold located at the junction of the gallbladder neck
junctional fold
Sources of diffuse gallbladder wall thickening
postprandial
acute cholecystitis
chronic cholecystitis
adenomyomatosis
hepatic dysfunction
benign ascites
hypoalbuninemia
AIDS cholangiopathy
congestive heart failure
gallbladder carcinoma
sources of focal gallbladder wall thickening
gallbladder polyp
adenomyomatosis
gallbladder carcinoma
adhered gallstone
risk factors and predisposing conditions for cholelithiasis
obesity
pregnancy
increased parity
gestational diabetes
estrogen therapy
oral contraceptive use
rapid weight loss programs
hemolytic disorder
Chron’s disease
total parenteral nutrition
Clinical findings of cholithiasis
asymptomatic
biliary colic
abdominal pain after fatty meals
epigastric pain
nausea and vomiting
pain that radiates to the shoulders
echogenic, mobile, shadowing structure(s) with the lumen of the gallbladder, stones that lodge within the cystic duct or neck of the gallbladder may not move; WES sign may be present
sonographic findings of cholelithiasis
A collection of low-level, nonshadowing, dependent, echoes within the gallbladder lumen
sonographic findings of gallbladder sludge
hyperechoic, nonshadowing, and nonmobile mass that projects from the gallbladder wall into the gallbladder lumen
sonographic findings of gallbladder polyps
focal or diffuse thickening of the gallbladder wall; comet-tail artifact that projects from the gallbladder wall into the lumen of the gallbladder
sonographic findings of Adenomyomatosis
RUQ tenderness
epigastic or abdominal pain
leukocytosis
possible elevation in ALP, ALP, GGT, and bilirubin (with obstruction)
fever
paid that radiates to the shoulders
nausea and vomiting
jaundice if there is an obstruction
clinical findings of acute cholecystitis
gallstones, positive sonographic Murphy sign, gallbladder wall thickening, gallbladder enlargement, pericholecystic fluid, sludge
sonographic findings of acute cholecystitis
RUQ pain, epigastric or abdominal pain, leukocystosis, possible elevation in ALP, ALT, GGT, and bilirubin, fever, pain that radiates to the shoulders, nausea and vomiting
clinical findings of gangrenous cholecystitis and Gallbladder perforation
galls stones, loss of the sonographic Murphy sign, gallbladder wall thickening with a possible perceptible wall tear, focal wall necrosis, bulges of the gallbladder wall, sloughed membranes, and ulcerative craters, gallbladder typically loses its shape, pericholecystic fluid, sludge
sonographic findings of gangrenous cholecystitis and gallbladder perforation
diabetic patient
RUQ pain, possible without Murphy sign
fever
can progress to sepsis
clinical findings of emphysematous cholecystitis
dirty shadowing reverberation, or ring-down artifact emanating from the gallbladder wall or gallbladder lumen consistent with air, champagne sign
sonographic findings of emphysematous cholecystitis
gas bubbles within the gallbladder wall may rise to the nondependent wall of the gallbladder
Champagne sign
intolerance to fatty foods because of subsequent abdominal pain; nontender gallbladder
clinical findings of chronic cholecystitis
contracted gallbladder; WES sign; gallstones; wall thickening
sonographic findings of chronic cholecystitis
RUQ tenderness, epigastric or abdominal pain, leukocytosis
clinical findings of acalculus cholecystitis
positive sonographic Murphy sign, gallbladder wall thickening, pericholecystic fluid, sludge
sonographic findings of alcalculous cholecystitis
palpable gallbladder, could suffer from painless jaundice, possible elevation in ALP, ALT, GGR, and bilirubin
clinical findings of gallbladder enlargement
gallbladder measures greater than 4-5 cm in diameter or greater than 8-10 cm in length
sonographic signs of gallbladder enlargement
calcification of the gallbladder wall recognized by an echogenic curvilinear structure within the gallbladder fossa with shadowing; the identification of the calcified posterior wall of the gallbladder is helpful to differentiate from the WES sign, signs of chronic cholecystitis may be present
sonographic findings of porcelain gallbladder
weight loss; RUQ pain; jaundice; nausea and vomiting; hepatomegaly; possible elevation in ALP, AST, GGT, and bilirubin
clinical findings of gallbladder carcinoma
nonmobile mass within the gallbladder lumen that measures greater than 1 cm; diffuse or focal gallbladder wall thickening; irregular mass that may completely fill the gallbladder fossa; invasion of the mass into surrounding liver tissue
sonographic findings of gallbladder carcinoma
Where is the gallbladder located/
posterior to the right lobe of the liver within the gallbladder fossa
The gallbladder is an ____peritoneal organ
intra
pear shaped sac, used to store and concentrate bile that is produced by liver
main lobar fissure
3 distinct layers to main lobar fissue
mucusal layer (innermost layer, consists of multiple folds and rugae)
fibromuscular layer (middle layer)
serosal layer (outer layer)
