Hepatobiliary Crash Course Flashcards
Most common anatomical location of pancreatic adenocarcinoma
Pancreatic head!
Often asymptomatic in early disease and therefore diagnosed late
Pancreatic adenocarcinoma anatomical location
Ca 19-9
E
Approx …% of pancreatic adenocarcinoma cases are respectable at diagnosis
What does he have?
Acute pancreatitis
Acute abdomen
Uncontrolled release of pancreatic enzymes
Can be mild to severe to life-threatening
Gallstones then alcohol
I GET SMASHED
A
Glasgow score - pancreatitis severity
Acute pancreatitis management
Supportive care with fluids and analgesia - catheter and fluid balance imp
Amylase test
Nutrition - enteral feeding preferred, NG/NJ if oral isnt tolerated
TPN if enteral route not tolerated
Further measures - cholecystectomy if gallstones are the cause
Antibiotics if infected necrosis or other source
Identify and manage complications
Appendicitis? Cholangitis? Biliary colic? Gastroenteritis? Acute cholecystitis?
Biliary colic
Biliary colic
Investigations in biliary colic
USS + LFTs
Most appropriate management option
Elective laparoscopic cholecystectomy
Murphy’s sign - what is it?
Palpate RUQ, elicits pain on inspiration
Acute cholecystitis
Gallstone may become impacted within the cystic duct
Impaired drainage leads to stasis and bacterial growth
Complications of acute cholecystitis
Perforation and empyema - but is uncommon
Overview of gallstone related pathology
What is best for CBD stone recognition?
MRCP
Hepatocellular cancer screening in cirrhosis patients?
6 monthly USS +/- AFP
Hepatocellular carcinoma
Primary liver cancer occurring predominantly in patients with cirrhosis
One of the major complications of cirrhosis and chronic hep B
Patients may be asymptomatic, picked up on screening
Others present with weight loss, sweats, mass, pain and jaundice
Hepatocellular carcinoma - management
