Gall bladder and bile duct Flashcards
Risk factors of gall stones
Fat
Female
(Forty)
Fertile
Describe biliary colic gallstones
when gallstone is impacted in the gallbladder neck temporarily and is dislodged back into the gallbladder
Describe acute cholecystitis
when the gallstone is stuck in the gallbladder neck and causes inflammation
Presentation of acute cholecystitis
RUQ pain, fever, nausea and vomiting
Murphy’s sign
Investigations of acute cholecystitis
US Scan abdomen
LFTs to exclude liver/bile duct pathology
Treatment of acute cholecystitis
Laproscopic cholecystectomy
Supportive - analgesia, fluids if needed
What is ascending cholangitis
Gallstone is stuck in Common Bile Duct
The flow of bile prevents intestinal bacteria from migrating up the biliary tree and this process is stopped due to the gallstone
Common bugs in ascending cholangitis
E. coli, klebsiella, enterococcus (group D strep)
Ascending Cholangitis:
What is Charcot’s triad and what is Reynold’s Pentad
Charcot’s triad: Fever, RUQ pain, Jaundice
Reynold’s Pentad: Hypotension and confusion
Investigations of ascending cholangitis
US scan abdomen
NRCP to locate stone
Treatment of ascending cholangitis
ERCP to remove stone