intro hepatobiliary and pancreatic system Flashcards
blood supply of the liver ?
portal vein and hepatic artery
physiological function of bile ?
made up of bile salts and bile pigments
bile salts:
fat emulsification
stimullation of peristalsis
antibacterial effect
Absorption of ADEK
liver function test ?
albumin
bilirubin
INR
which marker is elevated with hepatocellular carcinoma ?
alpha fetoprotein
what are the features associated with fibrolamellar hepatocellular carcinoma ?
young patient
normal alpha fetoprotein levels
central hypodense scar
what are hepatic adenomas commonly associated with ?
OCP
steriods
and are mainly seen in younger females
what is the most common benign lesion of the liver ?
cavernous hemangioma
what is seen on ultrasound imaging of simple cysts of the liver ?
posterior acoustic enhancement
what are the different parts of the CBD ?
supraduodenal
retroduodenal
intraduodenal
physiological function of the gallbladder :
storgae of the bilee
conceentration of the bile
normal choleedochoduodenal mechanism
what is the hormonal regulation of the gallbladder ?
secretin
CCK
what is the initial event in acute cholecystitis, and which area is the pain in ?
obstruction of gallbladder emptying
affected area is the right upper quadrant
what are the US findings in acute cholecystitis ?
oedematous GB wall
stones
what sign is positive for gallstones ?
positive murphy sign
ask the patient to take a deep breath and palpate the subcostal area
extreme pain upon palpation
what is the presentation of acute cholecystitis ?
extreme right upper quadrant pain
fever
abdominal guarding
fever
positive murphy’s sign
what is porcelain gallbladder ?
calcification of the inner wall of the gall bladder
what is the problem with porcelain gallbladder ?
increases the risk of gallbladder carcinoma
what is primary sclerosing cholangitis ?
bile ducts inside and outside the liver become inflamed and then fibrosed eventually becoming narrowed and blocked
what is the CT appearance of primary sclerosing cholangitis ?
beaded appearance due to alternating dilatation and stenosis
what is pathognomonic in primary sclerosing cholangitis ?
duct diverticula
what disease is commonly associated with primary sclerosing cholangitis ?
ulcerative colitis
what are choledochal cysts ?
congenital cystic dilatation of the bile ducts
mostly extra hepatic
what is caroli’s disease ?
multiple intra-hepatic cysts
what is Mirizzi syndrome ?
when a stone in the gallbladder or the cystic duct externally compresses the common hepatic duct causing obstructive jaundice
