Gallbladder

Question 1

% with gallbladder stones

Answer 1

5% of middle aged
20-40% of >50
70% of > 70

Question 2

% of gallbladder stone that make symptoms

Answer 2

1-2% per year, mostly colicks

Question 3

Gallbladder stone colick (typical clinic)

Answer 3

> 15 minutes
Postprandial
Epigastrum / RUQ

Question 4

Risk factors for more serious complications (2)

Answer 4

small stones

age

Question 5

Pathophysiology of acute cholecystitis

Answer 5

Obstruction (established or temporary) of cysticus
Gall acumulation
Wall ischemia

Question 6

Gallbladder wall >4mm also present in (5)

Answer 6

Acute Hepatitis
Hypertension
Hyponatremia
Hypoproteinemia
Right heart insuffiency

Question 7

Probability of choledocholithiasis by akute cholecystitis

Answer 7

10-20%

25% for people aged > 60

Question 8

Lab for Pancreatitis

Answer 8

Pancreatic amylase
- rises sooner than lipase

Lipase

• rises at 4-8h from symptom begin
• max at 24h
• stays high 14 days

Question 9

Gallbladder stones with gallstone pancreatitis

Answer 9

with obstruction : ERCP
without obstruction : no ERCP
if stones < 5mm, perform CCK after pancreatitis remission
if collection / pseudocyst : delay CCK 6 weeks.