Gallstones Flashcards
What is biliary colic?
Biliary colic is an acute, painful spasm of the gallbladder wall due to a gallstone temporarily blocking the neck of the gallbladder, cystic duct, or common bile duct.
What are the typical symptoms of biliary colic?
Sudden onset of severe, colicky pain in the right upper quadrant, which may radiate to the epigastric region, right shoulder, or interscapular region.
What usually precedes an episode of biliary colic?
Consumption of a fatty meal.
What is the aetiology of biliary colic?
Temporary obstruction of bile flow due to gallstones blocking the neck of the gallbladder, cystic duct, or common bile duct.
What is the pathophysiology of biliary colic?
Obstruction increases pressure in the gallbladder, leading to contraction against the blockage and resulting in visceral pain.
What is acute cholecystitis?
Acute cholecystitis is the inflammation of the gallbladder, typically due to persistent obstruction by a gallstone.
What are common symptoms of acute cholecystitis?
Severe, constant right upper quadrant pain, fever, nausea, vomiting, and positive Murphy’s sign.
What is the primary cause of acute cholecystitis?
Persistent obstruction of the cystic duct by a gallstone, leading to gallbladder inflammation.
What clinical examination finding is indicative of acute cholecystitis?
Positive Murphy’s sign: pain upon palpation of the right upper quadrant during deep inspiration.
What is acute cholangitis?
Acute cholangitis is a bacterial infection of the biliary tree, often due to bile duct obstruction.
What are the hallmark symptoms of acute cholangitis?
Charcot’s triad: right upper quadrant pain, fever, and jaundice.
What is the most common cause of acute cholangitis?
Bile duct obstruction, frequently due to gallstones.
What is Charcot’s triad?
A combination of right upper quadrant pain, fever, and jaundice, indicative of acute cholangitis.
What is the initial imaging modality for suspected biliary pathology?
Ultrasound of the abdomen.
What blood tests are commonly elevated in acute cholangitis?
Elevated white cell count, C-reactive protein, and liver function tests, particularly alkaline phosphatase and bilirubin.
What is the first-line treatment for acute cholecystitis?
Supportive care with intravenous fluids, antibiotics, and analgesia, followed by cholecystectomy.
What is the definitive treatment for biliary colic?
Elective cholecystectomy to remove the gallbladder and prevent recurrence.
What is the recommended management for acute cholangitis?
Intravenous antibiotics and biliary drainage, often via endoscopic retrograde cholangiopancreatography (ERCP).
What is the role of ERCP in biliary diseases?
ERCP is used for both diagnostic and therapeutic purposes, including biliary drainage and stone removal.
What are the potential complications of untreated acute cholecystitis?
Gallbladder gangrene, perforation, and peritonitis.
What is the significance of a positive Murphy’s sign?
It suggests gallbladder inflammation, commonly seen in acute cholecystitis.
What is the typical duration of pain in biliary colic?
Pain usually lasts less than 6 hours and resolves once the gallstone dislodges.
What differentiates biliary colic from acute cholecystitis?
Biliary colic involves temporary pain without inflammation, while acute cholecystitis includes persistent pain with gallbladder inflammation.
What is Reynold’s pentad?
Charcot’s triad plus hypotension and altered mental status, indicating severe acute cholangitis.
What lifestyle modification can reduce the risk of biliary colic?
Adopting a low-fat diet to decrease gallbladder stimulation and stone formation.
