Choledocholithiasis Flashcards
0
Q
Presentation?
A
Biliary colic
Obstructive jaundice
Fever -> cholangitis (charcots triad - fever, pain, jaundice)
1
Q
What is it and what are the types?
A
CBD stones
Secondary - from GB
Primary - from CBD, biliary stricture, primary sclerosing cholangitis
2
Q
What Ix?
A
Lab
CBE EUC LFT CRP
Serum lipase
COAGS (vit k is bile-dependent)
Rad
US GB + CBD to visualise stones in duct
MRCP
ERCP (can be diagnostic and therapeutic)
3
Q
Rx?
A
Stabilize immediate Rx and vitamin k
ERCP
If ERCP fails do laparotomy with CBD exploration
Elective cholecystectomy
4
Q
Complications of choledocholithesisias?
A
Cholangitis -> biliary sepsis COAGULOPATHY - less bile reaches small intestines - less fat absorption - less vit k absorption - decreased vit k clotting factors
