Gallbladder Flashcards
Pathophysiology of a biliary colic? Triggered by? Accompanied symptoms? Signs that are not seen? Time course? Can be aborted by?
Stone temporarily occludes cystic duct; nausea and vomiting; no signs of peritoneal irritation or systemic signs of inflammatory process; 10-30 minutes; anti-cholinergics
Ethnicities that have a higher incidence of gallstones?
Native Americans and Mexican-Americans
Radiation of pain from biliary colic extends to?
Right shoulder and back
Acute cholecystitis (versus Biliary colic)? Time course? Associated findings? Effect on LFTs?
Occlusion cystic duct by stone, and stone remains in cystic duct until inflammatory process develops
Constant pain, fever and leukocytosis, signs of peritoneal irritation
No changes
HIDA scan shows uptake in liver, common bile duct, duodenum, but not in gall bladder – diagnosis?
Cholecystitis
Management of acute cholecystitis? If no response? Who is likely to have no response?
- NPO, NG tube, IV fluids
- Antibiotics
- After cooldown phase, elective cholecystectomy
Emergency cholecystectomy; diabetics and men
Gallbladder obstruction that affects older patients with temperature spikes and very high WBC counts? Management?
Acute ascending cholangitis
- IV antibiotics
- emergency decompression (ERCP, or percutaneous transhepatic cholangiogram)
- Followed with cholecystectomy
Gallstone pancreatitis - stone impacted where?
Ampulla