Cholelithiasis Flashcards
What is it?
Microcrystals formed by XS of cholesterol relative to bile acids and lecithin precipitating into the gallstones.
What process makes gallstones possible?
Reabsorption in the concentration of the bile is the process which makes it possible
Who gets gallstones?
Fat (obesity) Female Foetus (pregnant) Forty or over Fair (caucasian)
Presentation of cholelthiasis?
Most are asymptomatic Biliary colic: when stone impacts duct Colecystitis Jaundice Pancreatitis Bowel obstruction IF itch, nausea, anorexia, jaundice, abnormal LFTs then do MRCP
What is biliary colic?
Gradual build up of pain in RUQ radiating to back and shoulders
Diagnosis of gallstones?
US - single best CT scan MRCP/ERCP HIDA EUS
Treatment for biliary colic?
Pain killers, advise low fat diet
Best treatment: laproscopic cholecystectomy
Ursodeoxycholic acid (if small-medium stones)
Atropine or GTN to relieve biliary spasm
Treatment acute cholecystitis?
GB is inflammed and CD obstructed (may develop infection)
- Give IV ABs and IV fluids
- Nil by mouth
- US to confirm diagnosis
- Urgent cholecystectomy
- ERCP- Endoscope and stone removal from CBD
Adverse effect of ursodeoxycholic acid?
Diarrhoea
Risk factors of stone moving to Cystic bile duct, what might it cause?
Jaundice
Cholangitis
Acute pancreatitis
