Gallstones Flashcards

1
Q

What is cholelithiasis?

A

Gall stone disease

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2
Q

How are gall stones formed?

A

Bile contains cholesterol, bile pigments and phospholipids.
If the concentrations vary, different stones may form.

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3
Q

What are the different types of gall stones?

A

Pigment- small, irregular
Cholesterol- large, often solitary
Mixed- faceted, most common

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4
Q

What causes pigment stones?

A

Haemolysis

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5
Q

What causes cholesterol stones?

A

Female, Age, Obesity

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6
Q

What are the risk factors for gall stones?

A

Age
Gender
Parity
OCP
Cholesterol (Obesity, CF)
Pigment
Haemolytic anaemia
Bile infection (E.coli)

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7
Q

When do gallstones become symptomatic?

A

Cystic duct obstruction
Common bile duct obstruction

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8
Q

What is biliary colic?

A

Recurrent upper abdominal pain
Occurs when gallstone blocks biliary ducts, especially the cystic duct
Common after eating fatty food

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9
Q

What is the treatment for biliary colic?

A

Early laparoscopic cholecystectomy

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10
Q

What is acute cholecystitis?

A

Inflammation of gall bladder usually due to gallstones blocking the cystic duct

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11
Q

What is the difference between acute cholecystitis and biliary colic?

A

Inflammatory component

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12
Q

What are the symptoms of acute cholecystitis?

A

Continuous epigastric pain
Vomiting fever
Local peritonism
GB mass

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13
Q

What is the treatment for acute cholecystitis?

A

NBM
Pain relief
IVI
Antibiotics
Laparoscopic cholecystectomy

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14
Q

When is cholecystostomy done?

A

Drainage of gall bladder
Elderly or high risk patients
Acalculous cholecystitis

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15
Q

What is chronic cholecystitis?

A

Chronic inflammation of the gall bladder

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16
Q

What is the main symptom of chronic cholecystitis?

A

Flatulent dyspepsia

17
Q

What is flatulent dyspepsia?

A

Vague abdominal discomfort
Distention
Nausea
Flatulence
Fat intolerance

18
Q

What is the treatment for chronic cholecystitis?

A

Cholecystectomy

19
Q

What are other presentations of gall stones?

A

Choledocholithiasis
Obstructive Jaundice
Cholangitis
Gallstone ileus
Pancreatitis
Mucocoele
Empyema
Mirizzi’s syndrome
Gall bladder necrosis

20
Q

What is Choledocholithiasis?

A

Common bile duct stones

21
Q

What is Obstructive jaundice?

A

Jaundice resulting from blockage of the bile ducts or abnormal retention of bile in the liver.

Pain
Dark urine
Pale stool
Pruritis
Steatorrhea

22
Q

What is cholangitis?

A

Infection and inflammation of bile duct system

23
Q

What is Charcot’s triad?

A

The symptoms of cholangitis:
- Jaundice
- RUQ pain with fever
- Rigors

24
Q

What is gallstone ileus?

A

A stone erodes through the gallbladder into the duodenum; it may then obstruct the terminal ileum.

25
What is Bouveret's syndrome?
Stone obstructs the duodenum Much less common than gallstone ileus
26
What is mucocoele?
Obstructed gallbladder fills with mucus
27
What is empyema?
Obstructed gallbladder fills with pus
28
What is Mirizzi's syndrome?
A stone in the gallbladder presses on the bile duct causing jaundice
29
Why is gallbladder necrosis rare?
Because of dual blood supply
30
What are the complications of gall stones in the gall bladder and cystic duct?
Biliary colic Acute and chronic cholecystitis Mucocoele Empyema Carcinoma Mirizzi's syndrome
31
What are the complications of gallstones in the bile duct?
Obstructive jaundice Cholangitis Pancreatitis
32
What are the complications of gallstones in the gut?
Gallstone ileus