Gallbladder pathology Flashcards
Stone within the gallbladder lumen will cause episodic obstruction of this duct
Cystic duct
Stone within this location may promote chronic inflammation (increased carcinoma risk), and may cause pressure ulcer or erode into loop of intestine (gallstone ileus)
Gallbladder lumen
Gallstone in this location will increase gallbladder pressure, causing RUQ pain
Cystic duct
Gallstone within this structure may lead to asymptomatic hydrops, or bacterial colonization (empyema)
Cystic duct
Is biliary/digestive function compromised in a gallstone within the cystic duct?
No
Does a gallstone in the cystic duct (causing obstruction) result in jaundice?
No
Does a gallstone in the common bile duct result in jaundice?
Yes
A gallstone in this location is called Choledocholithiasis
Common bile duct
Does a gallstone in the ampulla result in jaundice?
Yes
A gallstone in this location may also have bile reflux into pancreatic duct, causing acute pancreatitis
Ampullary stone
Persistent RUQ for less than 6 hours indicates this condition
Cystic duct obstruction (due to gallstone)
RUQ pain and tenderness for greater than 24 hours, along with guarding and fever, indicates this condition
Acute cholecystitis
(usually due to stones)
Histology of this condition shows evidence of ischemia or acute inflammation, edema, gallbladder distention, fibrinous exudate, and musocal ulceration
Acute cholecystitis
Cystic duct obstruction causes mucosal chemical irritation in this condition
Acute calculus cholecystitis
Post-obstructive bacterial proliferation can occur sometimes in this condition, leading to empyema, acute gangrenous cholecystitis, and emphysematous cholecystitis
Acute calculus cholecystitis
Is Acute calculus or acalculous cholecystitis seen in critically ill patients, probably with ischemic etiology?
Acalculous
Acute acalculus cholecystitis is probably from ischemia due to this terminal artery with no collaterals
Cystic duct artery
What causes irritation to mucosa in Acute acalculus cholecystitis?
Bile stasis
Condition due to long-term changes from gallbladder irritation, inflammation, or obstruction
Chronic cholecystitis
This condition most commonly occurs due to repeated acute cholecystitis
Chronic cholecystitis
Do the majority of patients with Chronic cholecystitis have gallstones?
Yes, >90%
Morphology of this condition will have fibromuscular hyperplasia of wall, chronic inflammation, Rokitansky-Aschoff sinuses, and dystrophic calcification
Chronic cholecystitis
Rokitansky-Aschoff sinuses are seen in this gallbladder condition
Chronic cholecystitis
Fibromuscular hyperplasia of gallbladder wall is seen in this condition, as well as dystrophic calcification
Chronic cholecystitis
Is gallbladder adenocarcinoma more common in males or females?
Females
Does gallbladder adenocarcinoma have a good prognosis?
NO
5-10% 5 year survival
Procelain gallbladder (calcified gallbladder wall) can occur in this condition, which is also common with gallstones and abnormal biliary tree
Gallbladder adenocarcinoma
