GI Section IV: GB Pathology Part 2: Sword of Destiny

Question 1

Classic scenario of Acute Acalculous Cholecystitis

Answer 1

1. Supersick patient or just narrowly escaped death final destination style
2. Thick wall + pericholecystic fluid
3. (+) HIDA scan (GB not visualized)

Question 2

What happens in Mirizzi Syndrome?

Answer 2

when the common hepatic duct is obstructed secondary to an impacted cystic duct stone = erodes into the CHD or GI tract

Question 3

Patients with Mirizzi Syndrome increases the co-incidence of?

Answer 3

GB CA (5x more risk)

Question 4

Bouverete Syndrome

Answer 4

Gallstone erodes through GB = forms fistula into nearby bowel = stone in proximal duodenum/stomach = upstream dilatation and distended stomach

Question 5

Gallstone ileus is common in?

Answer 5

Ileocecal Valve