Gallbladder and Biliary Tract - Pathoma Flashcards
What is biliary atresia?
failure to form or early destruction of extrahepatic biliary tree
What happens within the first three months of life if a patient has biliary atresia?
biliary obstruction
How does biliary atresia present?
- Jaundice
- conjugated bilirubin
- Cirrhosis
- backflow damage
What is Cholelithiasis?
solid, round stones in the gallbladder
What is Cholelithiasis due to?
- Precipitation of cholesterol or bilirubin in the bile
- supersaturation (high concentration)
- decreased phospholipids (e.g. lecithin) or bile acids (lose ability to solubilize)
- stasis
Are cholesterol stones usually radiolucent or opaque?
Usually radiolucent!
(don’t show up on x-ray)
What are the risk factors for cholesterol stones in Cholelithiasis?
- Age
- Estrogen (increases activity of HMG-CoA reductase)
- Clofibrate (lipid lowering agent)
- Native American ethnicity
- Crohn disease
- Cirrhosis
Are bilirubin stones radiolucent or radiopaque?
Radiopaque
(show up on x-ray)
What are the risk factors for bilirubin stones in Cholelithiasis?
- Extravascular hemolysis
- produce large amount of unconjugated bilirubin
- Biliary tract infection
- can de-conjugate bilirubin
- e.g. E.coli, Ascaris lumbricoides, Clonorchis sinesis
What are the 5 key complications that can result from Gallstones?
- Biliary colic
- due to gallbladder contraction against stone
- Acute and chronic cholecystitis
- inflammation of gallbladder wall (ischemia and bacteria overgrowth)
- Ascending cholangitis
- usually enteric gram-negative bacteria
- Gallstone ileus
- gallstone obstruct small bowel
- Gallbladder cancer
- adenocarcinoma
Where does the RUQ pain in Cholecystitis radiate to?
Right Scapula
What is Porcelain gallbladder?
Calcified gallbladder due to chronic cholecystitis.
What condition increases the incidence of Ascending Cholangitis?
Choledocholithiasis
How does Gallbladder Carcinoma classically present?
Cholecystitis in elderly woman
(increased risk if porcelain gallbladder)
poor prognosis
