Gallstones- emergency complications Flashcards
what is mirizzine syndrome?
gall bladder gets infected over time and sticks to common bile/hepatic duct which can lead to fistulas
what is a gallstone ileus?
gall stone leaves gall bladder and obstructs the terminal ileum.
6 Ix for biliary disease
US MRCP CT Abdo with contrast endoscopic US ERCP PTC- percutaneous transhepatic cholangiography
what can US show us about the biliary system
thickness of wall
ducts- if dilated
what can MRCP show us in the biliary system?
biliary anatomy
clear view of common bile duct
what can endoscopic US show us?
microlithiasis
what can you do with endoscopic US?
FNA biopsy
drainage of pancreatic abscess
3 complications of ERCP
pancreatitis
perforation
bleeding
2 things we can do with PTC
place stents, take brushings
3 reasons you get gallstones in pregnancy
- oestrogen increases cholesterol secretion into bile
- progesterone decreases bile acid secretion and slows gall bladder emptying
- weight changes precipitate symptommatic gallstones
2 complications of gallstones in pregnancy
induce miscarriage
preterm labour
what is cholelithiasis
asymptommatic gall stones
mx of cholelithiasis
watch and wait
what is biliary colic
gall stones that are symptommatic
3 symptoms and signs of biliary colic
severe RUQ pain, lasts 2-6h, N bloods
mx of biliary colic
elective cholecystectomy
what is cholecystitis
inflammation of gallbladder
4 symptoms and signs of cholecystitis
continuous RUQ pain lasting >12h, fever, increased inflam markers
mx of cholecystitis
abx, cholecystectomy
what is a mucocele
gall bladder blockage
3 symptoms and signs of mucocele
recurrent biliary colic, continuous RUQ pain, N bloods
what is empyema
collection of pus in gall bladder
symptoms and signs of empyema
same as cholecystitis, not responding to abx, swinging fever
2 mx of empyema
cholecystectomy, cholecystostomy
