Hepatobiliary Radiography - Brown

Question 1

What are the complications from ERCP?

Answer 1

Cholangitis, obstructive jaundice, acute pancreatitis, biliary cirrhosis

Question 2

Pancreatic trauma is a frequent cause of what?

What signs may be present?

Diagnosis made how?

Answer 2

Retroperitoneal hematomas

Grey-Turner, Cullen

CT

Question 4

How does a gall stone enter the bowel in gallstone ileus? Shows what on CT?

Answer 4

Cholecystoenteric fistula leading to air in biliary tree

Question 6

What is elevated in gallstone pancreatitis?

Tx?

Answer 6

Amylase
Lipase
ALT > AST

RUQ US, ERCP, cholecystectomy

Question 8

What is reynold’s pentad?

Answer 8

Fever, jaundice, RUQ pain, shock, mental status changes

Question 10

What is gallstone ileus a complication of?

Leads to what?

Answer 10

Cholelithiasis

Adhesions and pressure necrosis

Question 11

What is a late finding of ascending cholangitis?

Tx?

Answer 11

Intrahepatic abscesses at duct ends

ERCP (not acutely), IV Abs and fluids

Question 14

What is Rigler’s triad?

What can it complicate?

Answer 14

SBO
Gas w/in biliary tree
Gallstone (right iliac fossa)

Crohn’s

Question 15

What finding on HIDA or PIPIDA can confirm biliary dyskinesia?

Answer 15

CCK EF < 35-40% of normal

Question 17

What condition causes increased bilirubin and alkaline phosphatase levels?

Answer 17

Choledocholithiasis

Question 20

What is the most common cause of ascending cholangitis?

Answer 20

Choledocholithiasis

Question 21

What are the complications of acute cholecystitis?

Answer 21

Gangrene
Perforation
Cholecystoenteric fistula

Question 22

What is biliary dyskinesia (pain) a result from?

How to assess it?

Answer 22

Gallbladder motility disturbance

HIDA and PIPIDA

Question 25

What imaging and finding is confirmatory for acute cholecystitis?

Answer 25

US, gallbladder wall thickening or edema