Common Bile Duct Stones Flashcards
What causes Common Bile duct stones?
When gallstones move into the common bile ductand occlude the lumen
What happens?
The lumen of the bile duct is occluded so bile cannot be excreted and serious complications can ensue
Is it common?
Not as common as gallstones
Who does it affect?
Older females
Risk factors (5)
Age, Female, Obesity, High cholesterol diet, Smoking
Symptoms (3)
Biliary colic, fever, episodic
Signs (4)
Jaundice, Tachycardia, Murphys sign, Staetorrhoea
What bloods would you do?
ESR, CRP, FBC, LFT, Prothrombin time (reflects absorption of vitamin K (fat soluble)
Other Investigations (5)
Abdominal Ultrasound, CT, MRCP, Endoscopic USS, ERCP
Differentials (2)
Cholangitis, Malignant bile duct obstruction
Treatment (4)
I.V antibiotics for acute Cholecystitis, Urgent endoscopic bile duct drainage, cholecystectomy with bile duct, fluids and support
Complications (1)
Biliary Enteric Fistula (gallstones can erode into the bowel)
What is cholecystitis?
A stone in the cystic duct, shows raised alkaline phosphatase but normal bilirubin
What is Cholangitis?
Blockage of the common bile duct, patient is very unwell with jaundice and raised liver enzymes
