Gallstones Flashcards
What are the risk factors for gallstones?
Fat, Fertile, Forty, Female, FH
What are the three components of bile?
Cholesterol, bile pigments from broken down Hb, phospholipids
When do stones form?
When the concentrations of the components of bile vary
What are pigment stones?
Small, easily crumbled, irregular stones seen in haemolytic anaemia
What are cholesterol stones?
Large and often solitary
What is biliary colic?
When gallstones become symptomatic due to cystic duct or common bile duct obstruction
Which of Virchow’s triad does biliary colic present as?
Colicky RUQ pain that radiates to back
What is acute cholecystitis?
Inflammation occurs after stone or sludge is impacted in the neck of the gall bladder
Which of Virchow’s triad does acute cholecystitis present as?
RUQ pain that radiates to back, fever/increased WCC
What is the main difference between biliary colic and acute cholecystitis?
The inflammatory component
When is biliary colic pain worse?
After eating large or fatty meals
What would you expect to be raised in LFT in biliary colic?
ALP
What would you ultrasound in biliary colic?
Stones, Gallbladder wall thickness, duct dilation
How would you treat biliary colic?
NSAIDs/Analgesia, optional cholecystectomy
What is Murphy’s sign?
Severe pain on deep inhalation with examiners hand pressed into the RUQ
