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Abdominal Pathologies > Gallbladder Pathology > Flashcards

Gallbladder Pathology Flashcards

1
Q

Hartman’s pouch

A

fold in the neck of the gallbladder

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2
Q

Phrygian cap

A

fold in the fundus of the gallbladder

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3
Q

what is a complete septation of the gallbladder?

A

complete septation of the gallbladder is where the gallbladder has walls formed within itself

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4
Q

what is the potential concern for a gallbladder septations?

A

gallstones since the walls make it hard for bile to move around, so bile sits and become calcified

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5
Q

removal of the gallbladder

A

cholecystectomy

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6
Q

what happens to bile after the gallbladder is removed?

A

bile will go directly into the intestines. This can cause a lot of bowel issues for people who have gotten their gallbladder out since all the bile they produces goes straight to their bowels.

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7
Q

what are the normal measurements of the GB?

A

the normal measurements of the GB are
- 3cm TRV
- AP <7-10cm longitudinal
- wall thickness should be less than 3mm

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8
Q

what are the landmarks for the GB?

A

the GB should be located in the RUQ near the MLF and portal vein

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9
Q

what are the clinical symptoms of gallbladder disease

A

the clinical symptoms of gallbladder disease include RUQ pain after eating greasy foods, N/V, gallbladder attack, or jaundice

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10
Q

define sludge

A

thickened bile from bile stasis, which is when bile sits still for a long period of time

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11
Q

what patients are at risk for developing sludge?

A

patients with hyperalimentation therapy and with obstruction of the GB

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12
Q

what is the sonographic appearance of sludge or sludgeballs

A

sludgeballs appear more echogenic and dense compared to normal bile. it looks like a ball inside the GB that moves around freely within the GB

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13
Q

what are some causes of GB wall thickening

A

GB wall thickening is caused by cholecystitis, gallbladder perforation, gallbladder carcinoma, hepatitis and cirrhosis, ascites, renal failure, and right heart failure

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14
Q

what is cholecystitis?

A

cholecystitis is inflammation of the gallbladder

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15
Q

define acute cholecystitis

A

acute cholecystitis is caused by gallstones being impacted in the cystic duct or in the neck of the gallbladder.

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16
Q

what is the most common cause of acute cholecystitis?

A

gallstones

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17
Q

clinical signs of acute cholecystitis

A
  • acute RUQ pain (+ murphy’s sign)
  • fever
  • N/V
  • leukocyotsis
  • increased serum bilirubin and alkaline phosphate levels
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18
Q

what are the complications of acute cholecystitis?

A

may be serious and include empyema, emphysematous, or gangrenous cholecystitis, and perforation

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19
Q

what is the sonographic appearance of cholecystitis?

A

The sonographic appearance of acute cholecystitis:
- Wall > 3mm
- Distended gallbladder lumen > 4cm
- Gallstones
- Impacted stones in cystic duct of neck/ Hartman’s pouch of the gallbladder
- Positive murphy’s sign
- Increased doppler flow
- Pericholecystic fluid collection

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20
Q

define cholelithiasis

A

cholelithiasis is where a single, large gallstone or tiny gallstones are collected within the gallbladder

21
Q

what is the danger of cholelithiasis?

A

tiny stones in the gallbladder are the most dangerous because they can enter the bile ducts and obstruct the outflow of bile

22
Q

who is at risk for gallstones?

A

gallstones are most common in the 5fs
1) fat
2) female
3) forty
4) fertile
5) fair-skinned

23
Q

what are the symptoms of gallstones?

A
  • RUQ pain
  • radiation of pain to the shoulder after a high-fat meal
  • epigastric pain
  • N/V when the symptoms become acute

gallstones may also be asymptomatic until the stone lodges into the cystic or common bile duct

24
Q

what is a rare complication of acute cholecystitis?

A

emphysematous cholecystitis

25
Q

what is emphysematous cholecystitis?

A

rapidly progressive and 15% fatal in patients. it is associated with the presence of gas-forming bacteria in the gallbladder wall and lumen with extension into the biliary ducts

26
Q

what are the risk factors of emphysematous cholecystitis?

A
  • more present in men
  • 50% of patients are diabetic
  • gallstones may not be present in 30% to 50% of patients
27
Q

what is the sonographic appearance of emphysematous cholecystitis?

A

depends on the amount of gas within the wall of the gallbladder
- if the gas is intraluminal, a prominent and bright echo is demonstrated along the anterior wall with a ring down or comet-tail artifact directly posterior to the echogenic structure.

28
Q

define gangrenous cholecystitis

A

Gangrenous cholecystitis is a serious and painful complication of acute cholecystitis that my lead to perforation. It is where the gallbladder dies

29
Q

when can gangrenous cholecystitis occur?

A

this can occur after a prolonged infection, and causes the gallbladder to undergo necrosis

30
Q

what is the sonographic appearance of gangrenous cholecystitis?

A

-thickened GB wall and edematous with focal areas of exudate, hemorrhage, and necrosis. ulcerations and perforations may be present, resulting in the pericholecystic abscess or peritonitis

31
Q

define acalculus cholecystitis

A

the acute inflammation of the GB without the presence of cholelithiasis

32
Q

who is at risk for acalculus cholecystitis?

A

those who have depressed gastric motility; postoperative patients, trauma, burns, HIV, etc.

33
Q

how does acalculus cholecystitis appear on US?

A

thickening of GB wall, edema, and inflammation

34
Q

define chronic cholecystitis

A

the most common form of GB inflammation. it is the result of numerous GB attacks of acute cholecystitis with subsequent fibrosis (thickening) of the GB wall.

35
Q

what are the clinical symptoms of chronic cholecystitis?

A

transient RUQ pain but no tenderness like with acute

36
Q

define porcelain gallbladder

A

a rare occurrence where calcium is incrusted into the gallbladder wall

37
Q

what are the risk factors of porcelain gallbladder?

A
  • most common in females
  • usually found as a mass or by accident in an exam
38
Q

why is porcelain gallbladder a concern?

A

because 25% of patients with porcelain gallbladder develop cancer on the gallbladder wall

39
Q

what is the sonographic appearance of porcelain gallbladder?

A

bright echogenic echo is seen on a region of the gallbladder with posterior shadowing (WES sign)

40
Q

define cholesterolosis

A

a condition in which cholesterol is deposited within the lamina propria of the gallbladder

41
Q

what is another name for cholesterolosis?

A

“strawberry bladder” because the mucosa resembles a strawberry

42
Q

what is the sonographic appearance of cholesterolosis?

A

echogenic lines within the lumen of the gallbladder and attached to the walls on the inside of the gallbladder. these appear like the inside of a cave.

43
Q

define polyp

A

polyps are small, well-defined soft-tissue projections connected by the stalk to the gallbladder wall

44
Q

what is the sonographic appearance of a polyp?

A

polyps appear as echogenic balls/masses attached to the inside wall of the gallbladder; looks like the inside of a cave

45
Q

define adenomyomatosis

A

a hyperplastic change in the gallbladder wall. papilloma may occur singly or in groups and may be scattered over a large part of the mucosal surface of the gallbladder.

46
Q

what is the sonographic appearance of adenomyomatosis

A

cause a “ring down” appearance within the gallbladder that looks like the inside of a cave.

47
Q

what is the most common type of gallbladder cancer?

A

adenocarcinoma

48
Q

risk factors for gallbladder cancer?

A

gallbladder cancer is associated with 80% to 90% of patients with cholelithiasis

49
Q

what is the sonographic appearance of gallbladder cancer?

A

gallbladder cancer causes the thickening and rigidity of the gallbladder walls adenocarcinoma appears more echogenic compared to the surrounding tissues, it also appears ill-defined

Abdominal Pathologies (8 decks)

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