GI 5 Flashcards
gallstones risks
symp
ix
females forty fat fetus fair
asymp. biliary colic RUQ maybe shoulder
LFTs FBC Yes amylase USS
choledocholithiasis
worse after eating fatty foods
N vom
in CBD
cholecystitis is what symp ix cx treatment
infection of GB cos stone
RUQ pain, fever, murphys sign, fever, vom
mildly deranged LFTs occasionally, FBC, USS
chronic, mucocele, empyeme
conservative, lap cholecystetomy
mirizzi syndrome
stone in cystic ducts or neck of GB causing compression of CBD or CHD
GB abscess symptoms
ix
rx
RUQ pain. swinging fever, systemically unwell
USS +/- CT
surgery
gallstone obstructive jaundice symp
ix
rx
cx
jaundice pale stools dark urine itch
increases ALP GGT bili. USS MRCP ERCP
ERCP - sphincyerotomy, stent, removal
ascending cholangitis
ascending cholangitis is what symptoms ix treatment complications of ERCP
GS in CBD - infection of biliary system charcots - jaudice fever RUQ pain. itch rigors LFTs FBC amylase USS MRCP/ERCP fluid resus, cefuroxamine and metro ERCP and surgery
bleeding, duodenal perf, cholangitis, pancreatitis
gallstone ileus is what
treatment
stone erodes through duodenum
mechanical bowel obstruction
laparotomy and removal of stone
GB carcinoma who
symp
commonly what
asians F>M
abd pain N/V weight loss
adeno
cholangiocarcinoma symp what is it assoc w what ix rx
painless jaundice. abd pain. >55. weight loss
malig of biliary tree. assoc PSC
LFTs, Ca 199, Ca 125, CEA, abd USS, abd CT/MRI. MRCP ERCP
resection, transplant, palliative - stent radio
PSC is what in who symp ix rx cx
progressive fibrosis and elongation of biliary tract
men UC HIV
jaundice itch RUQ pain fatigue hepatomegaly
LFTs PANA and ANCA pos increased IgM. ERCP - beaded appearance
UDSA, pred, metho, ERCP, transplant
cholangiocarcinoma in 10%, increases risk of colorectal cancer
acute pancreatitis cause symp ix rx cx
GETSMASHED
epigastric pain -> back, N/V, grey turners, cullers
increased amylase HR temp, lipase, Ca. CRP, CXR/AXR, US CT MRCP
supportive
pseudocyst, abscess, RDS, renal failure, chronic
chronic pancreatitis is what cause symp ix rx
long term fibrosis and calcification w irreversible structure changes
excess alcohol. hereditary
chronic abd pain.s steotorrhoea
amylase may be normal. CT - dilatation/calcification
stop alcohol, enzyme supplements, opiods/NSAIDs - pain, surgery if pain intolerable
pancreatic cancer assoc with risk mostly what symp ix rx
chronic pancreatitis
DM smoking
exocrine tumour mostly ductal adeno in head
abd pain/back. jaundice dark urine pale stools decreased weight painless jaundice
USS - obstructed ducts. CT. USS.
surgery - whipplers, bergs
insulinoma
glucagoma
gastricoma
recurrent hypos
DM, dermatitis
increased gastric release - recurrent GI ulcers (ZE syndrome)
