Gall Bladder Diseases Flashcards
Cholelithasis is
Stone formation within the gallbladder
Cholelithasis symptoms
Colicky pain
Worse with fatty foods
Cholelithasis diagnosis is made by
Right upper quadrant USS
Cholelithasis treatment is
Elective Cholecystectomy
Cholecystitis is
Acute inflammation of the gall bladder, a gall bladder gets stuck in the cystic duct: Cystic duct obstruction causing inflammation
Cholecystitis symptoms include
positive Murphy sign
Constant pain
Fever
Leukocytosis
What is a Murphy sign test
Classically, Murphy’s sign is tested for during an abdominal examination in supine position; it is performed by asking the patient to breathe out and then gently placing the hand below the costal margin on the right side at the mid-clavicular line (the approximate location of the gallbladder). The patient is then instructed to breathe in. Normally, during inspiration, the abdominal contents are pushed downward as the diaphragm moves down (and lungs expand). If the patient stops breathing in (as the gallbladder is tender and, in moving downward, comes in contact with the examiner’s fingers) and winces with a “catch” in breath, the test is considered positive. In order for the test to be considered positive, the same maneuver must not elicit pain when performed on the left side.
Cholecystitis diagnosis is made by
RUQ USS/ CT Scan
Cholecystitis treatment includes
Cholecystectomy (Semi-Urgent)
Choledocolithasis is
Common bile duct obstruction with proximal inflammation
Choledocolithasis symptoms include
Obstructive jaundice
Dilated hepatic bile ducts
Choledocolithasis diagnosis is made by
MRCP / ERCP (MRCP is diagnostic only)
Cholangitis is
Common bile duct obstruction with infection - choledocolithasis and infection, blocking flow causing a backflow of bile
Symptoms of Cholangitis include
Charcots Triad
Fever
Jaundice
RUQ pain
Reynolds Pentad
Charcots Triad PLUS
Hypotension
Altered GCS
Inflammation of the entire bilary tree
Diagnosis of Cholangitis include
RUQ USS , ERCP
Treatment of Cholangitis includes
Emergency ERCP (can also be used for confirming diagnosis)
Charcots Triad includes
FEVER
JAUNDICE
RUQ PAIN
Reynolds Pentad includes
Fever
Jaundice
RUQ Pain
(Charcots triad)
PLUS
Hypotension
Altered GCS
(Reynolds pentad is a poor prognostication sign)
What are Gallstones?
Gallstones consist of deposits of the constitutes of bile, most commonly cholesterol. Many small stones or one or more large stones may form but they do not necessarily produce symtpoms
Predisposing factors to gallstones?
Changes in the composition of bile that affect the solubility of its constituents
high blood cholesterol levels
diabetes
female
obesity
several pregnancies in young women, especially when paired with obesity
What is the risk of leaving cholecystitis with no treatment
buildup of bile–> Inflammatory reaction
- bacterial infection
- - distension of the gallbladder
ascending cholangitis complications if not treated
Cholangitis which is a complete obstruction of the bilary tree with infection if left the infection can spread upwards towards the liver, causing liver abscesses.