Gallbladder and Biliary Tract Flashcards
Biliary Atresia
failure to form/destruction of extrahepatic biliary tree causing obstruction within the first 2 months of life and presents as jaundice (may cause cirrhosis)
Cholelithiasis (Gallstones)
precipitation of cholesterol or bilirubin due to supersaturation, decreased phospholipids/bile acids, or stasis
- cholesterol stones: radiolucent, yellow
- bilirubin stones: radiopaque; risk factors: extravascular hemolysis and biliary tract infection (Ascaris lumbricoides- round worm from poor sanitation; Clonorchis sinensis- in China, Korea and Vietnam increasing risk for stones, cholangitis and cholangiocarcinoma)
*complications: biliary colic, acute/chronic cholecystitis, ascending cholangitis, gallstone ileus, gallbladder cancer
Biliary Colic
waxing and waning pain from contraction against a stone in cystic duct (can ause acute pancreatitis or obstructive jaundice)
Acute Cholecystitis
inflammation of wall from impacted stone that caused dilatation with pressure ischemia, bacterial overgrowth and inflammation
presentation: RUQ pain radiating to right scapula, fever, high WBC, N/V, high alk phos
Chronic Cholecystitis
chronic inflammation from longstanding cholelithiasis–> herniation of mucosa into muscular wall (Rokitansky-Aschoff sinus) causing RUQ pain after eating
*complication: porcelain gallbladder (shrunken & hard from inflammation, fibrosis and dystrophic calcification)
Ascending Cholangitis
bacterial infection of bile ducts from ascending infection with gram negative bacteria presenting as sepsis, jaundice and abdominal pain
Gallstone Ileus
gallstone obstructs small bowel due to cholecystitis with fistula between gallbladder and small bowel
Gallbladder Carcinoma
adenocarcinoma from glandular epithelium that lines wall presenting as cholecystitis in an elderly woman
*gallstones and porcelain gallbladder= risk factors
