GI23 Flashcards
Types of Biliary Tract Diseases.
Primary biliary cirrhosis
Secondary biliary cirrhosis
Primary sclerosing cholangitis
Secondary biliary cirrhosis:
- Pathophysiology
- Extrahepatic biliary obstruction
- Increased pressure in intrahepatic ducts
- Injury/fibrosis and bile stasis
Primary biliary cirrhosis:
- Pathophysiology
- Autoimmune reaction
- Lymphocytic infiltrate + granulomas
Primary sclerosing cholangitis:
- Pathophysiology
- Unknown cause
- Concentric “onion skin” bile duct Fibrosis
- Alternating strictures and dilation with “beading” of intra- and extrahepatic bile ducts on ERCP
Causes of Extrahepatic biliary obstruction.
- Gallstone
- Biliary stricture
- Chronic pancreatitis
- Carcinoma of the pancreatic head
All Biliary tract diseases: Presentation
- Pruritis
- Jaundice
- Dark urine
- Light stools
- Hepatosplenomegaly
All Biliary tract diseases: Labs
INcreased:
- Conjugated bilirubin
- Cholesterol
- Alkaline phosphatase
Increased serum mitochondrial antibodies.
Primary biliary cirrhosis
Complicated by ascending cholangitis.
Secondary biliary cirrhosis
Hypergammaglobulinemia (IgM).
Primary sclerosing cholangitis
Can lead to 2˚ biliary cirrhosis.
Primary sclerosing cholangitis
Associated with autoimmune conditions (e.g., CREST, RA, celiac disease)
Primary biliary cirrhosis
“Beading” of intra- and extrahepatic bile ducts on ERCP.
Primary sclerosing cholangitis
