Cholecystitis

Question 1

Charcot triad
(Acute cholangitis due to choledocholithiasis)

Answer 1

Fever
Jaundice
RUQ abdo pain

Question 2

Asymptomatic cholesthiasis

Answer 2

presence of stones
No symptoms
No treatment

Question 3

Biliary colic

Answer 3

Hx of pain
Association with food
+/- nausea/vomit
No inflammation

Question 4

Acute Calculous Cholecystitis

Answer 4

Similar to biliar colic + SSx of inflammation - fever/elevated WBC
Positive Murphy’s sign
Gallstone impacted in the infundibulum or cystic duct, thickened GB wall, fluid and air

Question 5

Choledolithiasis

Answer 5

Jaundice, cholangitis
Migration of stones in the bile duct and impacted at the ampulla
Charcot triad
Reynold pentad - CT + septic shock and mental status changes

Question 6

Gallstone pancreatitis

Answer 6

Pancreatic duct obstruction:

• gallstone in lower bile duct adjacent to main pancreatic duct
• migration of gallstone through sphincter of Oddi into the duodenum

Question 7

Gallstone ileus

Answer 7

Erosion of the wall of the gallbladder - fistula between the GB and intestine
Distal small intestinal obstruction +/- Sx related to gallstones