Gallbladder Flashcards
Charcot’s triad
Fever + RUQ pain + jaundice → cholangitis
Raynaud’s pentad
- Fever
- RUQ pain
- jaundice
- confusion
- shock
( Cholangitis)
Rick factors for gallstones
Female, fat, fertile, forty
St5 of cholecystitis / choledocholithiasis
RUQ / epigastric pain, constant x hrs, severe. Murphy’s sign
Nausea /anorexia /vomiting
Low grade fever
Acholic stools, tea colored urine
Investigations for patient presenting with RUQ/epigastic pain suggestive of gallbladder pathology
↑ WBC with left shift
Alt, AST, alp, conjugated bilirubin
Lipase, amylase ( to r/o pancreatitis)
Blood culture if hx suggestive of cholangitis
U/s abdomen
U/s findings in cholecystitis
Thickened gall bladder wall >3mm
Pericholecystic fluid
Gallstone in cystic duct
Distended gallbladder
Management of cholecystitis
NPO
Iv fluids
Ng if persistent vomiting
Analgesia
Abx ampicillin + gentamicin + metronidazole
Surgery
Management of cholangitis
NPO, iv fluids, ng tube, analgesia
Antibiotics
Ercp with sphincterotomy. Can consider laparotomy
Complication of cholecystitis
Biliary obstruction
Duodenal Perforation
Cholangitis / sepsis
Hepatitis, pancreatitis
Cholecyst enteric fistula