Gallstone Diseases Flashcards
What are the 4 gallstone related pathologies in order of increasing severity?
1) Cholelithiasis
2) Cholecystitis
3) Choledocolithiasis
4) Cholangitis
What is cholelithiasis?
Stones inside the gallbladder
What is the main symptom of cholelithiasis?
Colicky RUQ pain usually after fatty foods (gall bladder contracts trying to push bile out)
What is the treatment for cholelithiasis?
Cholecystectomy
What can cholelithiasis lead to?
Any of the next more severe diseases
What is cholecystitis?
Inflammation of the gall bladder and cystic duct due to cystic duct obstruction by gallstone causing concentrated bile, pressure and possible infection
What sign is pathognomonic of cholecystitis?
Murphy’s sign = pain on palpation with inspiration
What are the symptoms of cholecystitis?
- Constant RUQ pain
- Fever
- Murphy’s sign
What is the treatment of cholecystitis?
Cholecystectomy + abx (IV co-amoxiclav)
What is the key difference between cholelithiasis & cholecystitis and choledocolithiasis & cholangitis?
The first two do NOT cause jaundice (the other two do)
What is choledocolithiasis?
Common bile duct obstruction by gallstone causing slight proximal inflammation
What are the symptoms of choledocolithiasis?
Jaundice ± pain (doesn’t cause much pain)
Why does choledocolithiasis lead to jaundice?
Bile can’t exit through the common bile duct so it leaks back into the liver and bloodstream
Why is choledocolithiasis v serious?
Bc it can lead to cholangitis
What is the treatment for choledocolithiasis?
ERCP (endoscopic retrograde cholangiopancreatography) - suck out the stone
