Gallbladder Path I Flashcards
sphincter of oddi
muscle at ampulla of vater
ampulla of vater
opening - emptying into duodenum
hartmanns pouch
pocket for stone location in gallbaldder
histo of gallbladder
single layer of smooth muscle
BM - under epithelial cells
tumor transverse BM - to lymphatics
aberrant location of gallbladder
deep in liver
coele
latin for cavity or space
cyst
abnormal lined closed space with fluid
-speudo - unlined
caroli disease
polycystic renal disease
ectasia
aneurysm in vasculature
choledochal cyst
-of common bile duct**
don’t remove surgically
most common in clinical
choledochocele
dilation at opening to duodenum
phyrigian cap
no clinical significance - but important to surgeon
infolding at tip of gallbladder
most common anomaly of gallbladder
causes indentation
gallbladder wall
very thin
cholelithiasis
gallstones
very common
majority don’t know it
risk of gallstones
infections - cholecystitis
obstruction
gallbladder cancer - chronic presence
acute pancreatitis
3 types of gallstones
cholesterol - most common
black
brown
cholesterol stones
majority
-yellow tan appearance
flat edges - long time - rubbing up against eachother
fat, female, fertile, forty
cholesterol gallstones
calcium carbonate
give hardness to cholesterol stone
and make seeing it on xray easier
path of cholesterol stones
supersaturation in gallbladder or biliary tree
lithogenic - easier to form stone
hypomotility - leads to sludge - important for stone formation
-thick stuff
-nidus - where stones crystallize on
cyst
abnormal bile flow - more likely stone formation
lumen of gallbladder
abnormal - more likely lithogenic bile to form stones
sludge
in gallbladder
can allow stone formation and bacterial growth
accretion of cholesterol
stone formation
nidus
nucleation for cholesterol formation of stone
increased cholesterol secretion
age, estrogen, obesity
pima indians
more cholesterol stones
crohns disease
more cholesterol stones
stone formation
supersatiration
crystallization - nidus
flow - turbulence
accretion - sludge
biliary tree/gallbladder
-and other organs - kidneys, bladder, prostate, salivary glands, pancreas
cholesterolosis
accumulation of cholesterol in mucosa of gallbladder
gives white yellow dots with red bkg - strawberry gallbladder
can cause gallbladder pain
strawberry gallbladder
cholesterolosis diagnosis**
black stones
polymers of unconjugated bilirubin
usually very small
see on xray
with chronic hemolysis
chronic hemolysis
black stones
brown stones
unconjugated bilirubin and cholesterol
with infection - e. coli and liver flukes - c. sinensis**
softer and crumble
don’t see on xray
c. sinensis
liver fluke - brown stone
cholecystitis
inflammation of gallbladder
choledocholithiasis
stones in bile duct
gallstone location
most formed in gallbladder
- can get stuck in cystic duct
- pushed to common bile duct
gallstone stuck in cystic duct
more stones - stasis
wall of gallbladder - can experience ischemia - induces inflammation - chronic or acute
predisposition to infection**
gallstone in common bile duct
obstruct bile from gallbladder and from liver
backup behind stone
- leads to more stone formation
- jaundice
- infection
- cancer
ascending cholangitis
ascending infection up biliary tree with gallstone
gallstone in common hepatopancreatic duct
acute pancreatitis can occur
with all the problems in liver and gallbladder
gallstone high up in bilary tree
abscess and infection
acalculous cholecystitis
critically ill
hypovolemic shock - ischemia to gallbladder - no stones
biliary dyskinesia
young women
gallbladder pain due to sphincter of oddi**
pressure gradient to the gallbladder
