Gallbladder pancreas Flashcards
Nerve supply of gallbladder
T8 and T9 (epigastric)
Vagus and sympa
How much bile formed per day
500-1000 ml
CCK action to gallbladder and sphincter of oddi?
GB Contraction
Sphincter of Oddi relaxation
Diagnostic studies for proximal and distal biliary ducts respectively:
Proximal bile duct: PTC (percutaneous transhepatic cholangiography)
Distal bile duct: ERCP
Sonographic signs of acute cholecystitis:
Gallbladder thickening
Pericholecystic fluid
Sonographic murphy’s
Most common type of gallstone
Cholesterol type
Gallstone type: SINGLE, large smooth
Pure cholesterol
Gallstone type: MULTIPLE, multifaceted “mulberry shaped”
Mixed type (>70% cholesterol)
Gallstone type: small brittle spiculated, calcium bilirubinate, carbonate and phosphate
Due to HEMOLYSIS and CIRRHOSIS
Black pigment stones
Gallstone type: soft and mushy, only stone that can arise from the bile ducts
Due to BACTERIAL INFXN or BILE STASIS
Brown pigment stones
Characterized by recurrent biliary colic and due to partial obstruction of the cystic duct
Chronic cholecystitis
Initiating event of acute checystitis
Obstruction of cystic duct
Cystic artery is a branch of
Right hepatic artery
Most specific test for gallstone
HIDA scan
Gold standard diagnostic test for chiledocholithiasis
ERCP