Lesson 2B (Part 2) Flashcards
Cholangiocarcinoma
Is a cancerous (malignant) growth in one of the ducts that carries bile from the liver to the small intestine
What are the risk factors for cholangiocarcinoma? (3)
- Age
- Recurrent biliary infections
- Stone disease
How is cholangiocarcinoma classified?
Based on anatomic location in liver
- poor prognosis
What are the classifications of cholangiocarcinoma? (3)
- Hilar
- Distal
- Intrahepatic
What is the most common classification of cholangiocarcinoma?
Hilar
- klatskins tumour
Where are klatskin tumours located?
In the porta hepatis
What does hilar cause?
Fibrous tissue formation
What are the symptoms of klatskins tumour? (4)
- Jaundice
- Pruritis
- Increased LFTS
- Nodes
What is the sonographic appearance of distal CBD cholangiocarcinoma?
- Polypoid masses seen frequently
- Expanding duc
- Hypovascular
What is a sign of distal CBD cholangiocarcinoma?
Jaundice
What is the most effective treatment for distal CBD cholangiocarcinoma?
Surgical resection
What kind of involvement is common with distal CBD cholangiocarcinoma?
Nodal
What is the second most common primary malignancy of liver?
Intrahepatic cholangiocarcinoma
What makes intrahepatic cholangiocarcinoma malignant? (2)
- Increased numbers of liver cirrhosis
2. Hep C
What is the sonographic appearance of intrahepatic cholangiocarcinoma? (2)
- Large solid hypovascular mass
2. Varying degrees of echogenicity
How is intrahepatic cholangiocarcinoma differentiated from HCC?
By the presence of ductal obstruction
What does metastases to the liver also cause?
Ductal obstruction
What is the HIDA scan most often used for? (2)
- To evaluate the gallbladder and the bile
- excreting function of your liver and to track the flow of bile from your liver into your small intestine - To measure the rate at which bile is released from your gallbladder (gallbladder ejection fraction)
What can HIDA diagnose? (5)
- Gallbladder inflammation
- cholecystitis - Bile duct obstruction
- Congenital abnormalities in the bile ducts
- such as biliary atresia - Postoperative complications
- such as bile leaks and fistulas - Assessment of liver transplant
Jaundice
A sign of one of the many possible underlying pathological processes that may occur
What is jaundice also known as?
Icterus
How does jaundice appear?
Appears as a yellowish pigmentation of the skin, whites of the eyes and other mucous membranes
What is one way jaundice is developed?
Hyperbilirubinemia
Hyperbilirubinemia
Increased levels of bilirubin in the blood and subsequently high levels of bilirubin are also in the extracellular fluid
How is bilirubin usually excreted? (2)
- Bile
2. Urine
Where is jaundice typically seen? (3)
- In liver diseases
- eg) hepatitis and cirrhosis - Liver/pancreatic cancer
- Obstruction of the biliary system
- eg) stones in the CBD
What is bilirubin?
The product from the breakdown of hemoglobin in old red blood cells
How does jaundice get its yellowish appearance?
Through the leakage of bilirubin into tissues
What are symptoms of jaundice? (5)
- Pruritis-itchiness
- Fatigue
- Abdominal pain
- Weight loss
- Vomiting
What are signs of jaundice? (3)
- Yellow discoloration of skin and eyes
- Fever
- Pale stools, dark urine
