GI - Gall bladder Flashcards
what are the 2 types of gallstone
cholesterol
pigment
how is a cholesterol stone formed
excess cholesterol on micelle surface which crystallises to form a solid stone
- female, obese, diabetes, genetic
how is a pigment stone formed
excess bilirubin on micelle surface caused by excess haemolysis e.g. haemolytic anaemia
what are 6 predisposing factors to gallstones
FAT FEMALE FORTY FERTILE FAIR diabetes
what investigations are done for gallstones
1st line - U/S
MRCP / ERCP for clarification / therapeutic
what is cholecystitis
inflammation of gallbladder usually associated with gallstones
what happens in acute cholecystitis
GS obstructing outflow of bile subsequent infection mucocele - dilation with mucus accumulation empyema rupture peritonitis intense adhesion (2-3 days)
what happens in chronic cholecystitis
GB wall thickened due to fibrosis but not distended
what is the treatment of gallstones
IV ABs and fluids
NBM
cholecystectomy
what is the treatment for gallstones not causing obstruction
supportive
what are some s/s of cholecystitis
Murphy's sign exacerbated by eating colicky pain RUQ pain - gradual build up jaundice itch pain may radiate to back/shoulder nausea / indigestion pain may last 2-6 hours
what is ascending cholangitis
an infection of the bile duct usually caused by bacteria ascending from its junction with the duodenum
how can gallstones cause pancreatitis
block sphincter of Oddi
what is biliary colic
when a gallstone impacts the cystic duct
What is gallstone ileus
gallstones impacted in distal ileum causing small bowel obstruction
