Cholecystitis Flashcards
Emphysematous cholecystitis TXT
ABX w/ urgent cholescystectomy (alt Per-Q cholescystectomy)
Emphysematous cholecystitis is ass/w what POP?
DM/Old
Chronic cholecystitis important finding is?
Fibrotic GB wall thickening - recurrent obstructs
ICU admit for?
Acute cholecystitis and Cholangitis
Cholangitis is?
An ascending infectionof the biliary tree
Normal CBD diameter is?
<5mm (+1 per decade or hx of cholecystectomy)
How can you visualize microlithiasis?
CT or U/S
Biliary sludge AKA
Microlithiasis
Acute cholecystitis labs?
Increased WBC/CRP
DX SOC for acute cholecystitis is?
U/S (differing all biliary tree etiologies and pancreatitis due to stones)
Acute cholecystitis features?
Localized RUQ pain w/ peritoneal irritation (increases severity) Rigidity/ Rebound TTP Murphy Sign \+- fever Jaundice (obstruct)
Pain relief w/ opioids for cholecystitis is ass/w?
Spasms of Sphincter of Oddi and Increased biliary pressure
Biliary colic can develop into?
Acute cholecystitis or
acute calculous cholescysistis
Acute Aclaculous cholecystitis is?
No stones (LC) but ML to have comps
Ass/w Major conditions/situations (burns, Septic shock)
RF- DM- X-IMM
Charcots/Reynolds triad/pentad is for?
Acute cholecystitis
Microlithiasis is composed of
cholesterol crystals
Calcium bilirubinate pigament
Calcium Salts
Biliary colic is ass/w?
Food intake or circadian rhythm (peaks at midnight)
Post-Cholecystectomy syndrome is?
MisDx + recent cholecystectomy = persistent ABD S/S or Leak
Admitting for cholangitis also reqs?
ER consult for ERCP
Acalculous cholecystitis is ass/w
inpt critically ill, X-imm, Fulminant and gangrene/perf
High M/M
CT w/ IV contrast - cholescintigraphy
Gallstone ileus is?
Mechanical SBO due to ectopic G.stone in intestinal lumen via biliary-enteric fistula
Cholecocholithiasis is? classes?
Stones in CBD ( or stricture/tumor)
Primary - Develops in CBD
2dy - Migrates into CBD from GB
DX criteria for acute cholecystitis?
Local signs (Murphy sign and RUQ pain/mass/TTP) SYS signs (Fever, ^CRP, ^ WBC) Imaging - consistent
ABNL LFTs is suggestive of?
CBD obstruction (GGT esp for Choledocholithiasis)